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Fatal Mycobacterium abscessus in a recipient of axicabtagene ciloleucel CAR-T: beware of T cells

Bone Marrow Transplantation volume 55, pages 1464–1465 (2020)Cite this article

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Axicabtagene ciloleucel (axi-cel) is a currently FDA-approved autologous anti-CD19 CAR-T indicated for relapsed/refractory large B-cell lymphoma [1]. We report a fatal Mycobacterium abscessus opportunistic infection in a recipient of axi-cel with resulting T-cell immunodeficiency.

A 52-year-old Caucasian woman was diagnosed with stage IVE T-cell histiocyte rich B-cell lymphoma. Immunohistochemistry analysis was positive for CD20 and PAX5, and negative for CD3, CD30, and CD15. Gene rearrangements of MYC, BCL-2, and BCL-6 were absent. She achieved a metabolic complete remission after cyclophosphamide plus rituximab followed by four cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone. However, she presented 30 days later with relapse disease which remained refractory to six cycles of rituximab, gemcitabine, and oxaliplatin; and was then referred for axi-cel therapy. She received lymphodepleting conditioning with fludarabine plus cyclophosphamide (days −5, −4, and −3), followed by axi-cel (day 0).

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References

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Authors and Affiliations

  1. Mayo Clinic Florida Division of Hematology Oncology, Jacksonville, FL, USA

    Adam M. Kase

  2. Mayo Clinic Florida Division of Hematology Oncology, Blood and Marrow Transplantation and Cellular Therapies Program, Jacksonville, FL, USA

    Hemant S. Murthy & Mohamed A. Kharfan-Dabaja

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  1. Adam M. Kase
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  2. Hemant S. Murthy
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  3. Mohamed A. Kharfan-Dabaja
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Correspondence to Adam M. Kase.

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Kase, A.M., Murthy, H.S. & Kharfan-Dabaja, M.A. Fatal Mycobacterium abscessus in a recipient of axicabtagene ciloleucel CAR-T: beware of T cells. Bone Marrow Transplant 55, 1464–1465 (2020). https://doi.org/10.1038/s41409-020-0808-6

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