Invasive Fungal Infections after CD19 CAR T-cell Therapy for B-Cell Lymphoma

Strategic Insights -

Research recently published in Clinical Microbiology and Infection has shed new light on the incidence and impact of invasive fungal infections (IFI) in patients with B-cell lymphoma treated with CD19 chimeric antigen receptor (CAR) T-cell therapy. According to a multicenter cohort study, 32 out of 1,012 patients (3.1%) presented with IFI between 2018 and 2022, with the median time to onset being 29.5 days. The study identified several risk factors associated with IFI, including advanced age, number of prior lines of therapy, prior allogeneic hematopoietic cell transplantation, anti-IL-1 receptor antagonist treatments, and pre-IFI bacterial infection.

Key Takeaways:

  • The incidence of IFI in patients with B-cell lymphoma treated with CD19 CAR T-cell therapy was 3.1% (32 out of 1,012 patients), with the majority being invasive aspergillosis and candidemia.
  • The median time to onset of IFI was 29.5 days, with the median overall survival of patients with IFI being 6 months compared to 25.4 months in the non-infected population.
  • Advanced age, number of prior lines of therapy, prior allogeneic hematopoietic cell transplantation, anti-IL-1 receptor antagonist treatments, and pre-IFI bacterial infection were identified as risk factors associated with IFI.
  • The IFI-related mortality rate among infected patients was 21.8%, highlighting the need for individualized prophylaxis and rapid diagnosis for high-risk patients.
  • The study suggests that patients with B-cell lymphoma treated with CD19 CAR T-cell therapy may benefit from prophylactic measures against IFI, particularly in high-risk patients.

Statistics:

  • 3.1% of patients with B-cell lymphoma treated with CD19 CAR T-cell therapy presented with IFI (32 out of 1,012 patients).
  • The median time to onset of IFI was 29.5 days.
  • 11 out of 32 patients with IFI had invasive aspergillosis, while 12 out of 32 patients had candidemia.
  • The IFI-related mortality rate among infected patients was 21.8% (7 out of 32 patients).
  • The median overall survival of patients with IFI was 6 months compared to 25.4 months in the non-infected population.
  • 1,012 patients were included in the study between 2018 and 2022.

Sources:

  • Clinical Microbiology and Infection, 2025. Invasive Fungal Infections after CD19 CAR T-cell Therapy for B-Cell Lymphoma: a LYSA study from the DESCAR-T Registry.
  • Amandine Durand, Amelie Bouvier, Vivien Dupont, Nicolas Gower, Cristina Castilla Lorente, Arnaud Campidelli, Remi Dulery, Jean-Pierre Gangneux, Magalie Joris, Martin Eloit, Christelle Latiere, Roberta di Blasi, Blandine Denis, Ludovic Gabellier, and Franck M. Publisher contact information for the journal Clinical Microbiology and Infection is: Elsevier Sci Ltd, 125 London Wall, London, England.