Late-Onset Invasive Aspergillosis With Pituitary Involvement and Dysfunction Following CD19 Chimeric Antigen Receptor T-Cell Therapy

IF 1.2

EJHaem Pub Date : 2025-09-02 DOI:10.1002/jha2.70138

Daisuke Ikeda, Tomohiro Nawada, Takumi Kondo, Takayuki Shinohara, Tomohiro Nagano, Saya Kubota, Ryuichiro Hiyama, Masaya Ueno, Hiroki Kobayashi, Keisuke Seike, Hideaki Fujiwara, Noboru Asada, Daisuke Ennishi, Keiko Fujii, Nobuharu Fujii, Masanori Makita, Yoshinobu Maeda

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Abstract

Introduction

Invasive fungal infection (IFI) after chimeric antigen receptor (CAR) T-cell therapy is less common than bacterial and viral infections, but can be fatal once it develops. As most cases occur within 30 days after CAR T-cell infusion, late-onset IFI—particularly mould infection—appears to be under-recognised.

Discussion

We report an illustrative case of pituitary aspergillosis developing as late as one year after CD19 CAR T-cell therapy, highlighting a persistent risk in certain patients with delayed immune reconstitution.

Conclusion

This case underscores the need for continued vigilance and individualised antifungal strategies to prevent IFI beyond the early post-infusion period.

Trial Registration

The authors have confirmed clinical trial registration is not needed for this submission.

Abstract Image

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CD19嵌合抗原受体t细胞治疗后伴垂体受累和功能障碍的迟发性侵袭性曲霉病

嵌合抗原受体（CAR） t细胞治疗后的侵袭性真菌感染（IFI）不像细菌和病毒感染那么常见，但一旦发生可能是致命的。由于大多数病例发生在CAR - t细胞输注后30天内，迟发性ifi——尤其是霉菌感染——似乎未得到充分认识。我们报告了一个说明性的垂体曲霉病病例，在CD19 CAR - t细胞治疗后发展到一年后，突出了某些延迟免疫重建的患者的持续风险。结论：该病例强调了持续警惕和个体化抗真菌策略的必要性，以防止输注后早期发生IFI。试验注册作者已确认该提交不需要临床试验注册。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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EJHaem

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