Pulmonary Immunocompromise in Stem Cell Transplantation and Cellular Therapy - 30/01/25

Doi : 10.1016/j.ccm.2024.10.010

Mahnoor Mir, MD ^a,^b, Saadia Faiz, MD ^b, Anuradha G. Bommakanti, MD ^a,^b, Ajay Sheshadri, MD, MSCI ^b,^⁎
^a Divisions of Critical Care, Pulmonary and Sleep Medicine, McGovern Medical School at UTHealth, Houston, TX 77030, USA
^b Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA

^∗Corresponding author. Department of Pulmonary Medicine, Unit 1462, The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Houston, TX 77030-1402.Department of Pulmonary MedicineUnit 1462The University of Texas MD Anderson Cancer CenterP.O. Box 301402HoustonTX77030-1402

Résumé

Hematopoietic cell transplantation (HCT) and cellular therapies, such as chimeric-antigen receptor T-cell (CAR-T) treatments, are potentially curative treatments for certain hematologic malignancies and some nonmalignant disorders. However, pulmonary complications, both infectious and noninfectious, remain a significant cause of morbidity and mortality in patients who receive cellular therapies. This review article provides an overview of pulmonary complications encountered in the context of HCT and CAR-T. The authors discuss mechanisms of underlying immunocompromise that lead to a rise in infections. Additionally, they highlight key noninfectious complications of HCT that can mimic acute infections and suggest diagnostic approaches and preventive strategies to distinguish these entities promptly.

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Keywords : Hematopoietic cell transplantation, Chimeric antigen receptor T-cell therapy, Immunocompromise, Pulmonary infections, Noninfectious pulmonary complications