ArticleCancer medicine2023
Procalcitonin as a biomarker for predicting bacterial infection in chimeric antigen receptor T-cell therapy recipients.
Article in Cancer medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 28 citations in OpenAlex.
- Pharmacovigilance in Cell and Gene Therapy: Evolving Challenges in Risk Management and Long-Term Follow-Up.Drug safety · 2026Review
- Prevalence and microbiological profile of septic complications following ECMO decannulation: a prospective single-center study.Scientific reports · 2025Article
- Mitigation and Management of Common Toxicities Associated with the Administration of CAR-T Therapies in Oncology Patients.Drug safety · 2025Review
- Clinical features, procalcitonin concentration, and bacterial infection in febrile hospitalized cancer patients: a descriptive study and association analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Proposed observational study protocol for early differentiation of cytokine release syndrome and sepsis in CAR-T recipients with haematological malignancies using the IL-6/PCT ratio: the DRACARYS study.Frontiers in oncology · 2025Article
- Rapid identification of early infections in febrile patients after CD19 target CAR-T cell therapy for B-cell malignancies.Journal of translational medicine · 2024Article
- Systemic toxicity of CAR-T therapy and potential monitoring indicators for toxicity prevention.Frontiers in immunology · 2024Review
- Article
- Tocilizumab and CytoSorb for delayed severe cytokine release syndrome after ipilimumab plus nivolumab immunotherapy.Immunotherapy · 2024Article
- Recognizing, defining, and managing CAR-T hematologic toxicities.Hematology. American Society of Hematology. Education Program · 2023Review
- The CAR-HEMATOTOX score identifies patients at high risk for hematological toxicity, infectious complications, and poor treatment outcomes following brexucabtagene autoleucel for relapsed or refractory MCL.American journal of hematology · 2023Observational
- The CAR-HEMATOTOX score as a prognostic model of toxicity and response in patients receiving BCMA-directed CAR-T for relapsed/refractory multiple myeloma.Journal of hematology & oncology · 2023Article
- Procalcitonin as a biomarker for predicting bacterial infection in chimeric antigen receptor T-cell therapy recipients.Cancer medicine · 2023Article
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Authors and funding
13 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is unknown whether serum procalcitonin (PCT) concentration monitoring can differentiate between bacterial infection or cytokine release syndrome (CRS) when chimeric antigen receptor T-cell (CAR-T) recipients present with a constellation of signs and symptoms that may represent both complications.
objectiveThe objective of the study was to assess the utility of serum PCT concentrations as a biomarker of bacterial infection in CAR-T recipients. STUDY
designThis single-center, retrospective, medical record review evaluated patients prescribed CAR-T therapy until death or 30 days after infusion. Logistic regression modeling determined the association between elevated serum PCT concentrations within 48 h of fever onset and microbiologically confirmed infection. Secondary outcomes included clinically suspected infection, CAR-T toxicity rates, and broad-spectrum antibiotic usage. Predictive performance of PCT was assessed by area under the receiver operating characteristic curve (AUC).
resultsThe 98 included patients were a median age of 63 (IQR: 55-69) years old, 47 (48%) were male, and 87 (89%) were Caucasian. Baseline demographics and clinical characteristics were similar between patients with and without a bacterial infection. Serum PCT >0.4 ng/mL within 48 h of fever was significantly associated with a microbiologically confirmed bacterial infection (OR: 2.75 [95% CI: 1.02-7.39], p = 0.045). Median PCT values in patients with and without confirmed infections were 0.40 ng/mL (IQR: 0.26, 0.74) and 0.26 ng/mL (IQR: 0.13, 0.47), respectively. The AUC for PCT to predict bacterial infection was 0.62 (95% CI 0.48-0.76). All patients experienced CRS of some grade, with no difference in CRS severity based on elevated PCT. Broad-spectrum antibiotics were used for a median of 45% and 23% of days in those with and without confirmed infection, respectively (p = 0.075).
conclusionElevated serum PCT concentrations above 0.4 ng/mL at time of first fever after CAR-T infusion was significantly associated with confirmed bacterial infection. Furthermore, rigorous, prospective studies should validate our findings and evaluate serial PCT measurements to optimize antimicrobial use after CAR-T therapy.
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