Infections in haematology patients treated with CAR-T therapies: A systematic review and meta-analysis.

2023-12

Reynolds, Gemma K

Sim, Beatrice

Spelman, Tim

Thomas, Ashmitha

Longhitano, Anthony

Anderson, Mary Ann

Thursky, Karin

Slavin, Monica

Teh, Benjamin W

CAR-T

Cellular therapies

Infections

Lymphoma

Myeloma

Journal Article

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10.1016/j.critrevonc.2023.104134

A registered (PROSPERO - CRD42022346462) systematic review and meta-analysis was conducted of all-grade infections amongst adult patients receiving CAR-T therapy for haematological malignancy. Meta-analysis of pooled incidence, using random effects model, was conducted. Cochran's Q test examined heterogeneity. 2678 patients across 33 studies were included in the primary outcome. Forty-percent of patients (95% CI: 0.33 - 0.48) experienced an infection of any grade. Twenty-five percent of infection events (95% CI: 0.16 - 0.34) were severe. Late infections were as common as early infections (IRR = 0.86, 95% CI: 0.38 - 1.98). All-grade infections, bacterial and viral infections were highest in myeloma patients at 57%, 37% and 28% respectively. Patients with NHL more commonly experienced late infections. Pooled rate of invasive candidiasis/yeast infections was 2% in studies utilizing anti-yeast prophylaxis. This review identified a high rate of all-grade infections, moderate rate of severe infections, and myeloma as a high-risk haematological group.

link

Critical Reviews in Oncology/Hematology 2023-12; 192

Critical Reviews in Oncology/Hematology

1879-0461