Human herpesvirus 6 reactivation and disease are infrequent in chimeric antigen receptor T-cell therapy recipients.

Details

Serval ID
serval:BIB_75C8676C98E9
Type
Article: article from journal or magazin.
Collection
Publications
Title
Human herpesvirus 6 reactivation and disease are infrequent in chimeric antigen receptor T-cell therapy recipients.
Journal
Blood
Author(s)
Kampouri E., Krantz E.M., Xie H., Ibrahimi S.S., Kiem E.S., Sekhon M.K., Liang E.C., Cowan A.J., Portuguese A., Green D.J., Albittar A., Huang J.J., Gauthier J., Pérez-Osorio A.C., Jerome K.R., Zerr D.M., Boeckh M.J., Hill J.A.
ISSN
1528-0020 (Electronic)
ISSN-L
0006-4971
Publication state
Published
Issued date
01/08/2024
Peer-reviewed
Oui
Volume
144
Number
5
Pages
490-495
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
Publication Status: ppublish
Abstract
Human herpesvirus 6B (HHV-6B) reactivation and disease are increasingly reported after chimeric antigen receptor (CAR) T-cell therapy (CARTx). HHV-6 reactivation in the CAR T-cell product was recently reported, raising questions about product and patient management. Because of overlapping manifestations with immune effector cell-associated neurotoxicity syndrome, diagnosing HHV-6B encephalitis is challenging. We provide 2 lines of evidence assessing the incidence and outcomes of HHV-6B after CARTx. First, in a prospective study with weekly HHV-6B testing for up to 12 weeks after infusion, HHV-6B reactivation occurred in 8 of 89 participants; 3 had chromosomally integrated HHV-6 and were excluded, resulting in a cumulative incidence of HHV-6B reactivation of 6% (95% confidence interval [CI], 2.2-12.5). HHV-6B detection was low level (median peak, 435 copies per mL; interquartile range, 164-979) and did not require therapy. Second, we retrospectively analyzed HHV-6B detection in the blood and/or cerebrospinal fluid (CSF) within 12 weeks after infusion in CARTx recipients. Of 626 patients, 24 had symptom-driven plasma testing, with detection in 1. Among 34 patients with CSF HHV-6 testing, 1 patient had possible HHV-6 encephalitis for a cumulative incidence of 0.17% (95% CI, 0.02-0.94), although symptoms improved without treatment. Our data demonstrate that HHV-6B reactivation and disease are infrequent after CARTx. Routine HHV-6 monitoring is not warranted.
Keywords
Humans, Herpesvirus 6, Human/immunology, Male, Female, Middle Aged, Adult, Roseolovirus Infections/immunology, Roseolovirus Infections/virology, Roseolovirus Infections/therapy, Roseolovirus Infections/diagnosis, Receptors, Chimeric Antigen/immunology, Virus Activation/immunology, Immunotherapy, Adoptive/methods, Immunotherapy, Adoptive/adverse effects, Aged, Prospective Studies, Retrospective Studies, Young Adult, Incidence
Pubmed
Web of science
Open Access
Yes
Create date
10/01/2025 11:23
Last modification date
13/01/2025 7:04
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