{"doi":"10.1093/cid/ciad708","title":"Cytomegalovirus (CMV) Reactivation and CMV-Specific Cell-Mediated Immunity After Chimeric Antigen Receptor T-Cell Therapy","abstract":"BACKGROUND: The epidemiology of cytomegalovirus (CMV) after chimeric antigen receptor-modified T-cell immunotherapy (CARTx) is poorly understood owing to a lack of routine surveillance. METHODS: We prospectively enrolled 72 adult CMV-seropositive CD19-, CD20-, or BCMA-targeted CARTx recipients and tested plasma samples for CMV before and weekly up to 12 weeks after CARTx. We assessed CMV-specific cell-mediated immunity (CMV-CMI) before and 2 and 4 weeks after CARTx, using an interferon γ release assay to quantify T-cell responses to IE-1 and pp65. We tested pre-CARTx samples to calculate a risk score for cytopenias and infection (CAR-HEMATOTOX). We used Cox regression to evaluate CMV risk factors and evaluated the predictive performance of CMV-CMI for CMV reactivation in receiver operator characteristic curves. RESULTS: CMV was detected in 1 patient (1.4%) before and in 18 (25%) after CARTx, for a cumulative incidence of 27% (95% confidence interval, 16.8-38.2). The median CMV viral load (interquartile range) was 127 (interquartile range, 61-276) IU/mL, with no end-organ disease observed; 5 patients received preemptive therapy based on clinical results. CMV-CMI values reached a nadir 2 weeks after infusion and recovered to baseline levels by week 4. In adjusted models, BCMA-CARTx (vs CD19/CD20) and corticosteroid use for >3 days were significantly associated with CMV reactivation, and possible associations were detected for lower week 2 CMV-CMI and more prior antitumor regimens. The cumulative incidence of CMV reactivation almost doubled when stratified by BCMA-CARTx target and use of corticosteroids for >3 days (46% and 49%, respectively). CONCLUSIONS: CMV testing could be considered between 2 and 6 weeks in high-risk CARTx recipients.","journal":"Clinical Infectious Diseases","year":2023,"id":319984,"datarank":0.5955437870328184,"base_score":3.970291913552122,"endowment":3.970291913552122,"self_citation_contribution":0.5955437870328184,"citation_network_contribution":0.0,"self_endowment_contribution":0.5955437870328184,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":52,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.962,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1030362,"name":"Sarah Ibrahimi","orcid":null,"position":1,"is_corresponding":false},{"id":345766,"name":"Hu Xie","orcid":"0000-0003-0556-6591","position":2,"is_corresponding":false},{"id":1030363,"name":"Elizabeth R Wong","orcid":null,"position":3,"is_corresponding":false},{"id":1030364,"name":"Jessica Hecht","orcid":null,"position":4,"is_corresponding":false},{"id":1029848,"name":"Mandeep K Sekhon","orcid":"0009-0003-0087-6256","position":5,"is_corresponding":false},{"id":1030365,"name":"Alythia Vo","orcid":null,"position":6,"is_corresponding":false},{"id":277659,"name":"Terry Stevens‐Ayers","orcid":"0000-0002-7546-8439","position":7,"is_corresponding":false},{"id":522226,"name":"Damian J. Green","orcid":"0000-0003-0477-1446","position":8,"is_corresponding":false},{"id":233383,"name":"Jordan Gauthier","orcid":"0000-0002-5769-8409","position":9,"is_corresponding":false},{"id":232698,"name":"David G. Maloney","orcid":"0000-0002-8477-6919","position":10,"is_corresponding":false},{"id":1030366,"name":"Ailyn Perez","orcid":null,"position":11,"is_corresponding":false},{"id":108343,"name":"Keith R. Jerome","orcid":"0000-0002-8212-3789","position":12,"is_corresponding":false},{"id":230926,"name":"Wendy M. Leisenring","orcid":"0000-0001-7405-0906","position":13,"is_corresponding":false},{"id":1030367,"name":"Michael J Boeckh","orcid":null,"position":14,"is_corresponding":false},{"id":513613,"name":"Joshua A. Hill","orcid":"0000-0002-3617-6142","position":15,"is_corresponding":false},{"id":1029847,"name":"Eleftheria Kampouri","orcid":"0000-0001-8019-3073","position":0,"is_corresponding":true}],"reference_count":40,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:07:17.361058Z","pmid":"37975819","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}