Human herpesvirus 6 myelitis after chimeric antigen receptor T-cell therapy.

Abstract

This article reports a fatal case of human herpesvirus 6 (HHV-6) myelitis following CD19-targeted chimeric antigen receptor T-cell therapy. Infection from HHV-6 reactivation after haematopoietic stem cell transplant is established, and outside of this population is limited to case reports. The patient developed cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome that responded to corticosteroids both clinically and on imaging. Subsequently, ascending flaccid paralysis developed, leading to neuromuscular respiratory failure and, ultimately, death. Disease progression was refractory to foscarnet and multiple immunomodulating agents. HHV-6 should be considered in patients with encephalitis and myelitis after adoptive T-cell therapy.

• Authors: Guy Handley, Fareed Khawaja, Divya S Kondapi, Hun J Lee, Gregory P Kaufman, Sattva S Neelapu, Luis E Fayad, Sudhakar Tummala, Linda Chi, Paolo Strati, Victor E Mulanovich
• Journal: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases (Int J Infect Dis) Vol. 112 Pg. 327-329 (Nov 2021) ISSN: 1878-3511 [Electronic] Canada
• PMID: 34600133 (Publication Type: Case Reports)
• Copyright: Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

Chemical References

• Receptors, Chimeric Antigen

Topics

• Cell- and Tissue-Based Therapy
• Herpesvirus 6, Human
• Humans
• Immunotherapy, Adoptive
• Myelitis (drug therapy, etiology)
• Receptors, Chimeric Antigen