ArticleBMC infectious diseases2021
Severe Candida glabrata pancolitis and fatal Aspergillus fumigatus pulmonary infection in the setting of bone marrow aplasia after CD19-directed CAR T-cell therapy - a case report.
Article in BMC infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 1 of them a synthesis that pooled it.
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Who cites it
40 citing papers in PubMed, 1 synthesis or guideline pooled it, 51 citations in OpenAlex.
- Virulence and resistance factors of Nakaseomyces glabratus (formerly known as Candida glabrata) in Europe: A systematic review.Journal of the European Academy of Dermatology and Venereology : JEADV · 2025Pooled it
- Functional and molecular characterization ofJournal of medical microbiology · 2026Article
- Noncanonical and mortality-defining toxicities of CAR T cell therapy.Nature medicine · 2025Review
- Immune effector cell-associated hematotoxicity: mechanisms, clinical manifestations, and management strategies.Haematologica · 2025Review
- Human autoimmunity at single cell resolution in aplastic anemia before and after effective immunotherapy.Nature communications · 2025Article
- Article
- Recent developments inMicrobiology and molecular biology reviews : MMBR · 2025Review
- Prognostic significance of immune reconstitution following CD19 CAR T-cell therapy for relapsed/refractory B-cell lymphoma.HemaSphere · 2025Article
- Targeting GPRC5D for multiple myeloma therapy.Journal of hematology & oncology · 2024Review
- Immune effector cell-associated haematotoxicity after CAR T-cell therapy: from mechanism to management.The Lancet. Haematology · 2024Review
- Applying the EHA/EBMT grading for ICAHT after CAR-T: comparative incidence and association with infections and mortality.Blood advances · 2024Observational
- Rapid diagnosis ofFrontiers in medicine · 2024Article
- Managing Infection Complications in the Setting of Chimeric Antigen Receptor T cell (CAR-T) Therapy.Clinical hematology international · 2024Review
- Essentials of CAR-T Therapy and Associated Microbial Challenges in Long Run Immunotherapy.Journal of cellular immunology · 2024Article
- Recognizing, defining, and managing CAR-T hematologic toxicities.Hematology. American Society of Hematology. Education Program · 2023Review
- The CAR-HEMATOTOX score identifies patients at high risk for hematological toxicity, infectious complications, and poor treatment outcomes following brexucabtagene autoleucel for relapsed or refractory MCL.American journal of hematology · 2023Observational
- Bone Marrow Aplasia after CAR-T-Cell Therapy for Relapsed/Refractory Burkitt's Lymphoma.Medical sciences (Basel, Switzerland) · 2023Article
- Review
- Severe hematotoxicity after CD19 CAR-T therapy is associated with suppressive immune dysregulation and limited CAR-T expansion.Science advances · 2023Article
- The CAR-HEMATOTOX score as a prognostic model of toxicity and response in patients receiving BCMA-directed CAR-T for relapsed/refractory multiple myeloma.Journal of hematology & oncology · 2023Article
Corrections and comments
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Authors and funding
15 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundProlonged myelosuppression following CD19-directed CAR T-cell transfusion represents an important, yet underreported, adverse event. The resulting neutropenia and multifactorial immunosuppression can facilitate severe infectious complications. CASE PRESENTATION: We describe the clinical course of a 59-year-old patient with relapsed/refractory DLBCL who received Axicabtagene-Ciloleucel (Axi-cel). The patient developed ASTCT grade I CRS and grade IV ICANS, necessitating admission to the neurological ICU and prolonged application of high-dose corticosteroids and other immunosuppressive agents. Importantly, neutropenia was profound (ANC < 100/μl), G-CSF-refractory, and prolonged, lasting more than 50 days. The patient developed severe septic shock 3 weeks after CAR transfusion while receiving anti-fungal prophylaxis with micafungin. His clinical status stabilized with broad anti-infective treatment and intensive supportive measures. An autologous stem cell backup was employed on day 46 to support hematopoietic recovery. Although the counts of the patient eventually started to recover, he developed an invasive pulmonary aspergillosis, which ultimately lead to respiratory failure and death. Postmortem examination revealed signs of Candida glabrata pancolitis.
conclusionsThis case highlights the increased risk for fatal infectious complications in patients who present with profound and prolonged cytopenia after CAR T-cell therapy. We describe a rare case of C. glabrata pancolitis associated with multifactorial immunosuppression. Although our patient succumbed to a fatal fungal infection, autologous stem cell boost was able to spur hematopoiesis and may represent an important therapeutic strategy for DLBCL patients with CAR T-cell associated bone marrow aplasia who have underwent prior stem cell harvest.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.