2708. Infectious Complications Among CD19 Chimeric Antigen Receptor T-cell Recipients

Abstract

Abstract Background Current data on infectious complications of chimeric antigen receptor (CAR) T-cell therapy are limited to single center retrospective cohort studies. Presented here is a subset of patients from a multicenter retrospective cohort study including recipients of CAR T-cell therapy at Duke University, University of North Carolina at Chapel Hill, and Stanford University. Methods In a retrospective cohort of 66 patients who received CD19 CAR T-cell therapy Duke University between January 1, 2018 and August 31, 2021 rates and characteristics of bacterial, viral, and fungal infections within the first year after CAR T-cell infusion are described. Demographic, baseline clinical, and outcome variables are compared between patients who developed infection and those who did not. Results Forty-nine total infections occurred in 29 (43.9%) patients within 1 year of CAR T-cell infusion. Patients who developed infection were more likely to have an underlying malignancy other than diffuse large B-cell lymphoma (34% vs 8%, p = 0.031), and to have developed immune effector cell-associated neurotoxicity syndrome (62% vs. 32%, p = 0.016). Viral (23/49, 46.9%) and bacterial (20/49, 40.8%) pathogens predominated and infections most often involved the bloodstream (19/49, 38.8%) and lung (18/49, 36.7%).There were no statistically significant differences between rates of bacterial and viral infection based on time since CAR T-cell infusion (≤30 days vs 30 – 90 days vs >90 days), though fungal infections only occurred after 90 days in patients with relapse of their underlying disease. Conclusion Infectious complications after CAR T-cell therapy are common within the first year of infusion. Bacterial and viral infections predominate while fungal infections are rare and occurred only in patients with relapsed disease. Disclosures Melody Smith, MD, MS, BMS: Advisor/Consultant Krista Rowe-Nichols, RN, MSN, AOCNS, Bristol Myers Squibb: Advisor/Consultant|Kite Pharmaceuticals: Advisor/Consultant|Kite Pharmaceuticals: Speaker Bureau Christopher Kelsey, MD, Colgate-Palmolive: Expert Testimony|Johnson and Johnson: Expert Testimony Taewoong Choi, MD, Janssen biotech: Honoraria Matthew McKinney, MD, ADC Therapeutics: Advisor/Consultant|ADC Therapeutics: Honoraria|Beigene: Grant/Research Support|Beigene: Honoraria|Epizyme: Advisor/Consultant|Genentech: Advisor/Consultant|Genentech: Grant/Research Support|Genentech: Honoraria|Gilead/Kite: Advisor/Consultant|Gilead/Kite: Honoraria|Incyte: Grant/Research Support|Novartis: Advisor/Consultant|Seagen, Inc.: Advisor/Consultant|Takeda: Advisor/Consultant|TG therapeutics: Advisor/Consultant