Rare Fungal Infection Complications Following CAR T-Cell Therapy for Lymphoma

CAR T-cell therapy is a treatment for certain types of blood cancers, including B-cell lymphoma. However, researchers have identified complications related to this treatment, including infections caused by rare fungal pathogens. Recently, a case of Schizophyllum commune infection was reported in a patient treated with CAR T-cell therapy. This rare fungal pathogen typically affects the respiratory tract and can mimic chronic pulmonary aspergillosis. The patient responded favorably to 4 months of oral voriconazole therapy, with resolution of symptoms and radiologic findings.

Key Takeaways:

• Schizophyllum commune is a rare fungal pathogen that typically affects the respiratory tract and may mimic chronic pulmonary aspergillosis.
• Infections caused by S. commune have been primarily reported in recipients of allogeneic hematopoietic stem cell transplantation.
• A 71-year-old woman with primary refractory large B-cell lymphoma received lisocabtagene maraleucel as second-line therapy, which led to an S. commune infection presenting as allergic bronchopulmonary mycosis (ABPM).
• The patient responded favorably to 4 months of oral voriconazole therapy, with resolution of symptoms and radiologic findings.
• The case highlights the potential for rare fungal infections to occur following CAR T-cell therapy.
• The diagnosis of S. commune infection was confirmed through bronchoscopic biopsy, fungal culture, and internal transcribed spacer gene region sequencing.
• The patient's serologic tests were negative for fungus-specific specific immunoglobulin G and immunoglobulin E, underscoring the diagnostic challenges posed by B-cell aplasia resulting from B-cell-directed immunotherapy.

Statistics:

• 71 years old: The age of the patient who contracted the S. commune infection.
• 6 months post-treatment: The time when radiologic findings revealed right middle lobe atelectasis with high-attenuation mucus.
• 4 months: The duration of oral voriconazole therapy the patient received to treat the infection.
• 65(3):210-217: The page range and issue number of the Journal of Clinical and Experimental Hematopathology where the research was published.

Sources:

• NewsRx. Data on Lymphoma Discussed by Researchers at National Cancer Center Hospital (Schizophyllum commune infection following chimeric antigen receptor T-cell therapy in a patient with lymphoma). Hematology Week. October 13, 2025; p 87.
• Makita, S., Nishiyama, R., Shiotsuka, M., Kobayashi, O., Watanabe, A., Maeshima, A. M., Ochi, T., Iwaki, N., Fukuhara, S., Munakata, W., & Izutsu, K. (2025). Schizophyllum commune infection following chimeric antigen receptor T-cell therapy in a patient with lymphoma. Journal of Clinical and Experimental Hematopathology, 65(3), 210-217.