• Curr Opin Crit Care · Oct 2022

    Review

    Severe infections in recipients of cancer immunotherapy: what intensivists need to know.

    • Adrien Joseph, Antoine Lafarge, Asma Mabrouki, Moustafa Abdel-Nabey, Yannick Binois, Romy Younan, and Elie Azoulay.
    • Medical Intensive Care Unit, Saint-Louis Teaching Hospital, Public Assistance Hospitals of Paris, Paris, France.
    • Curr Opin Crit Care. 2022 Oct 1; 28 (5): 540550540-550.

    Purpose Of ReviewGiven the increased number of cancer patients admitted in the ICU and the growing importance of immunotherapy in their therapeutic arsenal, intensivists will be increasingly confronted to patients treated with immunotherapies who will present with complications, infectious and immunologic.Recent FindingsApart from their specific immunologic toxicities, cancer immunotherapy recipients also have specific immune dysfunction and face increased infectious risks that may lead to intensive care unit admission.SummaryChimeric antigen receptor T-cell therapy is associated with profound immunosuppression and the risks of bacterial, fungal and viral infections vary according to the time since infusion.Immune checkpoint blockers are associated with an overall favorable safety profile but associations of checkpoint blockers and corticosteroids and immunosuppressive drugs prescribed to treat immune-related adverse events are associated with increased risks of bacterial and fungal infections.The T-cell engaging bispecific therapy blinatumomab causes profound B-cell aplasia, hypogammaglobulinemia and neutropenia, but seems to be associated with fewer infectious adverse events compared with standard intensive chemotherapy.Lastly, intravesical administration of Bacillus Calmette-Guérin (BCG) can lead to disseminated BCGitis and severe sepsis requiring a specific antibiotherapy, often associated with corticosteroid treatment.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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