Hemorrhagic Cystitis Secondary to Adenovirus and BK Virus Infection in a Diffuse Large B-Cell Lymphoma Patient with Recent CAR T-Cell Therapy.

Abstract

Patients who undergo chimeric antigen receptor T-cell therapy (CAR T-cell therapy) are immunosuppressed due to multiple factors. While adenovirus and BK virus are well-known pathogens in the context of hematopoietic stem cell transplant, there are no detailed reports of these infections in the setting of CAR T-cell therapy. We describe a 70-year-old male who recently underwent CAR T-cell therapy for diffuse large B-cell lymphoma. He presented with intractable gross hematuria and dysuria. Workup revealed adenovirus viremia and viruria and BK virus viruria. He was treated for adenovirus hemorrhagic cystitis with intravenous cidofovir 1 mg/kg/day, every three days for three weeks, with good clinical response. We also discuss the mechanisms of immunosuppression in CAR T-cell therapy as well as the principles of treatment of adenovirus and BK virus infections in the immunosuppressed patient.

• Authors: Abdul Moiz Khan, Zainub Ajmal, Fatima Tuz Zahra, Ananthakrishnan Ramani, Ira Zackon
• Journal: Case reports in hematology (Case Rep Hematol) Vol. 2020 Pg. 6621967 ( 2020) ISSN: 2090-6560 [Print] United States
• PMID: 33294236 (Publication Type: Case Reports)
• Copyright: Copyright © 2020 Abdul Moiz Khan et al.