Severe cytomegalovirus disease with encephalitis after CAR-T cell therapy: A rare but potentially fatal complication

J Med Virol. 2021 Nov;93(11):6398-6403. doi: 10.1002/jmv.27257. Epub 2021 Aug 14.

Abstract

Cytomegalovirus (CMV) is a ubiquitous herpes virus that develops lifelong latency following primary infection and can be reactivated following immune suppression. CMV encephalopathy has been described in few reports after hematopoietic stem cell transplantation and in patients with acquired immunodeficiency syndrome. To the best of our knowledge, CMV encephalopathy following CAR-T cells infusion had not been previously reported. Initial CMV viral load and monitoring are crucial in patients with CAR-T cells to allow early intervention with aggressive antiviral treatment without delay if needed.

Keywords: CAR-T cells therapy; CMV encephalopathy; immunosupressions.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Brain / diagnostic imaging
  • Brain / virology
  • Cytomegalovirus / genetics
  • Cytomegalovirus / pathogenicity*
  • Cytomegalovirus Infections / complications
  • Cytomegalovirus Infections / diagnostic imaging*
  • Cytomegalovirus Infections / etiology*
  • Cytomegalovirus Infections / therapy
  • Encephalitis, Viral / diagnosis
  • Encephalitis, Viral / etiology*
  • Fatal Outcome
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Humans
  • Immunotherapy, Adoptive / adverse effects*
  • Magnetic Resonance Imaging
  • Male
  • Patient Acuity
  • Transplantation, Homologous / adverse effects
  • Viral Load