Following the initial 30 days postinfusion, respiratory viruses and pneumonia are the predominant infectious complications of CAR T-cell therapy. Receipt of tocilizumab, development of ICANS, and neutropenia are associated with increased infection risk.

Multidisciplinary engagement between various teams is needed to help navigate the diagnostic and management challenges of mycobacterial infections in patients with hematologic malignancies and stem cell transplant recipients. Drug-drug interactions should always be considered. Therapeutic drug monitoring can be considered in certain situations.

Letermovir was effective in controlling cytomegalovirus (CMV) viremia when it was given at a lower starting CMV viral load and later post-allogeneic hematopoietic cell transplantation than valganciclovir.

In this single center retrospective study, we evaluated the incidence of breakthrough invasive fungal infections (bIFIs) in patients with hematologic malignancies and recipients of hematopoietic stem cell transplant and cellular therapies on isavuconazole prophylaxis. We noted bIFIs in 17.9%, with no potential risk factors for infection identified on univariate analysis.

Pre-transplant surveillance cultures from stool samples and throat swabs revealed a high prevalence of Gram-negative MDRO (85.9%) in the study population. This was significantly associated with a higher 100-day (14%) and 100-day (14%) to 6-month (25%) all-cause post-transplant mortality in the patient cohort.

We reviewed infectious complications in patients up to 2 years after receiving CD19 CAR T-cell therapy. Infectious complications were common after receiving CD19 CAR T-cell therapy, occurred frequently beyond the first year, and additional studies are needed to optimize antimicrobial prophylaxis in this patient population.

The role of primary and secondary prophylaxis is still uncertain and not standardized. New approaches are being explored for the prevention of Clostridioides difficile infection in allogeneic hematopoietic cell transplant patients, including antibiotic neutralization strategies and vaccines. Finally, correct hygiene procedures and patient isolation are mandatory to control the diffusion of this pathogen that can cause local epidemic clusters.