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Changes in C-Reactive Protein Forecast Infection Risk Following Treatment with Chimeric Antigen Receptor T Cells.

BACKGROUND: Immunosuppressive conditioning regimens for chimeric antigen receptor-modified T cell immunotherapy (CARTx) and subsequent T cell dysfunction increase risk for infection. However, it is difficult to discern infection from CRS in the early (up to Day 30) and late (Days 31-180) periods after CARTx due to overlapping signs and symptoms. METHODS: We analyzed infectious complications and predictors of infection during the early and late periods after CARTx in 213 adult patients with malignancies over a 5-year period. RESULTS: Overall, 75 patients (35%) had at least one infection, most

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… 20) | 21 (28) | 22 (16) | 0.05 Isavuconazole | 9 (4.2) | 3 (4.0) | 6 (4.4) | 1.0 Micafungin | 24 (11) | 13 (17) | 11 (8.0) | 0.04 PJP | | | | None | 9 (4.2) | 2 (2.7) | 7 (5.1) | 0.50 Trimethoprim-sulfamethoxazole | 40 (19) | 12 (16) | 28 (20) | 0.47 Dapsone | 9 (4.2) | 1 (1.3) | 8 (5.8) | 0.16 Atovaquone …

Практические рекомендации в отношении инфекционных профилактических мероприятий и вакцинации нескольких пациентов, страдающих миэломой.

Инфекции по-прежнему являются одной из основных причин заболеваемости и смертности во множестве миеломы (ММ), обусловленной взаимосвязью между иммунной дисфункцией, вызванной болезнями, и иммунодепрессией, связанной с лечением. Внедрение протеазных ингибиторов, иммуномодуляционных препаратов, моноклонных антител, биконкретных антител и химеорической антигенной рецепторной терапии Т (CAR-T) заметно улучшило выживание при одновременном изменении ландшафта инфекционных рисков. Различные стратегии обращения ставят под угрозу иммунитет в рамках различных механизмов. Обычная химиотерапия и некоторые

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… tocilizumab dose, anakinra/siltuximab, high-dose steroids >3 days ASCT/BsAb: per individual risk assessment | During neutropenia and high-risk period Reassess at ANC recovery Pneumocystis jirovecii (PJP) | TMP/SMX 80/400 mg OD or 160/800 mg 3×/week (first-line) Alternatives: Dapsone 50 mg twice daily Atovaquone … Patients with sulfonamide allergies should be given alternatives, such as atovaquone (1,500 mg daily), dapsone (50 mg twice daily), or aerosolized pentamidine (300 mg once monthly). …

Hemophagocytic Lymphohistiocytosis (HLH) in Patients with Tick-Borne Illness: A Scoping Review of 98 Cases.

Hemophagocytic lymphohistiocytosis (HLH) secondary to tick-borne infections is a rare but potentially life-threatening syndrome. We performed a scoping review according to PRISMA guidelines to systematically analyze the existing literature on the topic. A total of 98 patients were included, with a mean age of 43.7 years, of which 64% were men. Most cases, 31%, were reported from the USA. Immunosuppression was present in 21.4%, with the most common cause being previous solid organ transplantation. Constitutional symptoms were the most common, observed in 83.7% of the patients, while fever was r

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… For babesiosis, the treatment includes atovaquone and azithromycin. For viral pathogens, the therapy is supportive [ 114 ]. The role of immunosuppressants in secondary HLH has been questioned. …

How I treat cytopenias after CAR T-cell therapy.

Increasing use of chimeric antigen receptor T-cell therapy (CAR-T) has unveiled diverse toxicities warranting specific recognition and management. Cytopenias occurring after CAR-T infusion invariably manifest early (90 days). Variable etiologies of these cytopenias, some of which remain incompletely understood, create clinical conundrums and uncertainties about optimal management strategies. These cytopenias may cause additional sequelae, decreased quality of life, and increased resource use. Early cytopenias are typically attributed to lymphodepletion chemotherapy, however, infections and hyp

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… we typically initiate anti-PJP prophylaxis at day 30 and advocate for a CD4 + count driven approach to its discontinuation when CD4 + T-cell counts are >200, which can take from 1 to 2 years or longer. 10 We commonly use trimethoprim-sulfamethoxazole for PJP prophylaxis, and consider pentamidine or atovaquone …

Breathing new life into T-cell receptor-engineered T-cell therapy in solid tumors: enhancing strategies to expand the universality of precision therapy.

Adoptive T-cell transfer therapy (ACT) has significantly propelled the advancement of tumor immunotherapy. Among various strategies targeting solid tumors, the T-cell receptor (TCR)-engineered T-cell (TCR-T cell) therapy has emerged as a highly promising approach, exhibiting an expanded therapeutic window across diverse patient populations and superior tumoricidal activity in certain solid malignancies compared with chimeric antigen receptor T cell (CAR-T) and tumor-infiltrating T cells/lymphocyte (TIL) therapies. However, its clinical efficacy remains constrained. In this paper, we introduce

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… Atovaquone (ATO) induces ROS accumulation and up-regulation of HLA Class-I expression in tumor cells, and when combined with AFP-specific TCR-T cell therapy, not only improves cytotoxicity of engineered T cells but also potentiates ferroptosis of tumor cells [ 148 ]. …

CAR T-Cell Terrapy Opveiled: Навигация за пределы ССЗ и ИКАНС для решения проблем, связанных с отсроченными последствиями, и оптимизации стратегий управления.

Цимерическая антигенная рецепторная (КАР) T-клетологическая терапия положила начало эпохе преобразований в регулировании рецидивов/отсутствий гематологической гематологии. Кульминацией интенсивных испытаний второго этапа, направленных на борьбу с повторной/охотничьей лимфомой, включая различные подтипы, такие, как диффузная большая лимфома B-клеток, фолликулярная лимфома и лимфома мантичной клетки, а также многочисленные миелома и острая лимфоболическая лейкемия B-клеток, стало одобрение различных продуктов CAR-T-клеток для этих конкретных указаний Администрацией по вопросам продовольствия и н

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… 1 year after CAR T-cell therapy, and until CD4+ per mm 3 | Trimethoprim-sulfamethoxazole 160/800 MWF | Sulfa allergy, myelosuppression, dose adjust for renal function Alternative: Pentamidine 300 mg IV or inhalation monthly | Pancreatitis Alternative: Dapsone 100 mg daily | Check G6PD Alternative: Atovaquone …

Immunodeficiencies in Adults: Key Considerations for Diagnosis and Management.

Immunodeficiencies in adults are increasingly recognized yet often remain underdiagnosed, leading to significant morbidity from recurrent infections, autoimmunity, and malignancy. Both primary immunodeficiencies (PIDs), now known as inborn errors of immunity (IEI), and secondary immunodeficiencies (SIDs) contribute to immune dysfunction in adults. Although SIDs are more common in adults due to factors like medications, malignancies, metabolic disorders, chronic conditions, and protein-losing conditions, IEI-particularly common variable immunodeficiency (CVID)-can also manifest in adulthood wit

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… If TMP-SMX cannot be used, alternatives for Pneumocystis jirovecii include atovaquone or aerosolized pentamidine. …

Human herpesvirus type 6 reactivation after haploidentical hematopoietic cell transplantation with post-transplant cyclophosphamide and antithymocyte globulin: risk factors and clinical impact.

Human herpesvirus type 6 (HHV6) reactivation after haploidentical hematopoietic cell transplantation (HCT) with post-transplant cyclophosphamide (PT-Cy) has been scarcely studied, especially when antithymocyte globulin (ATG) is added to the graft-versus-host disease (GvHD) prophylaxis. We conducted a retrospective cohort study in 100 consecutive patients receiving haploidentical HCT with PT-Cy. We systematically monitored HHV6 DNA loads in blood samples on a weekly basis using quantitative PCR until day +100. The 100-day cumulative incidence of HHV6 reactivation was 54%. Clinically significant

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… Infection prophylaxis consisted of amoxicillin, trimethoprim-sulfamethoxazole (or atovaquone), and valacyclovir (or acyclovir). …

Roadmap for new practitioners to navigate the multiple myeloma landscape.

Multiple myeloma (MM) is a blood cancer in which monoclonal plasma cells cause end organ damage resulting in hypercalcemia, renal failure, anemia, and bone lesions. MM is considered incurable, however, recent advances in treatment have improved survival. Historically, MM has been treated with immunomodulatory drugs (IMiDs), proteosome inhibitors (PIs), and corticosteroids. While newer therapeutic approaches such as monoclonal antibodies and cellular therapies have broadened the treatment horizon, the selection and sequencing of these therapies has become more complex. This review aims to help

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… PJP prophylaxis with sulfamethoxazole/trimethoprim is the preferred strategy, however dapsone, atovaquone, and pentamidine are alternative agents for patients with clinically significant drug-drug interactions, hypersensitivity, or intolerance with sulfamethoxazole/trimethoprim [ 56 ]. …

Management of Adverse Reactions for BCMA-Directed Therapy in Relapsed Multiple Myeloma: A Focused Review.

Anti-B-cell maturation antigen therapies consisting of bispecific antibodies, antibody-drug conjugates, and chimeric antigen receptor T cells have shown promising results in relapsed refractory multiple myeloma (RRMM). However, the severe side effects include cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome, cytopenia(s), infections, hemophagocytic lymphohistiocytosis, and organ toxicity, which could sometimes be life-threatening. This review focuses on these most common complications post-BCMA therapy. We discussed the risk factors, pathogenesis, clinical feat

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… Alternatives include dapsone 100 mg PO daily, pentamidine 300 mg inhaled monthly, or atovaquone 1500 mg PO daily. …

Respiratory Tract Infections: Sinusitis, Bronchitis, and Pneumonia

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… Oral atovaquone, primaquine plus clindamycin, and parenteral pentamidine may be given to patients who are intolerant of sulfa-containing regimens. …

Multidisciplinary Management of Morbidities Associated with Chronic Graft-Versus-Host Disease.

Chronic graft-versus-host disease (cGVHD) represents a common long-term complication after allogeneic hematopoietic stem cell transplantation (HSCT). It imposes a significant morbidity burden and is the leading cause of non-relapse mortality among long-term HSCT survivors. cGVHD can manifest in nearly any organ, severely affecting the quality of life of a transplant survivor. While the mainstay of treatment has remained systemic immunosuppression with glucocorticoids, progress has been made within the last few years with approvals of three oral agents to treat steroid-refractory cGVHD: ibrutin

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… transplant center. 34 In general, patients with cGVHD on high dose steroids warrant prophylactic agents against fungal organisms with azole antifungals, against Varicella and Herpes simplex viruses with acyclovir or valacyclovir, and against Pneumocystis with trimethoprim-sulfamethoxazole, dapsone, atovaquone …

Infections associated with CAR-T cell therapy in patients with relapsed refractory multiple myeloma: Risks and prevention strategies.

BackgroundChimeric antigen receptor T (CAR-T) cell therapy has emerged as a potent treatment for relapsed or refractory multiple myeloma, demonstrating significant clinical efficacy. Despite these advances, treatment-related toxicities, particularly infections, pose a significant challenge to patient safety.MethodsThis review synthesizes current knowledge on the mechanisms underlying post-CAR-T therapy infections, focusing on the interplay between immune dysfunction, host factors, and treatment-induced toxicity. It provides a comprehensive analysis of the temporal and individual variability in

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… of lymphopenia and the associated risk of Pneumocystis jiroveci pneumonia (PJP), it is recommended that all patients use co‐trimoxazole for PJP prophylaxis when tolerated. 21 , 71 In cases where patients exhibit an allergic reaction to co‐trimoxazole, an alternative prophylactic regimen comprising atovaquone …

Pneumonia in Transplant Recipients: A Comprehensive Review of Diagnosis and Management.

Transplant recipients have an increased risk of complications, including graft dysfunction and infections, which can be life-threatening if not recognized early. Pneumonia ranks as one of the most frequent complications in both solid organ and hematopoietic stem cell transplants. Clinical symptoms manifest late during infections in immunocompromised patients. An aggressive approach centered on early confirmatory diagnosis and a low threshold for empiric therapy is often the most effective strategy. The isolation of a pathogen in an upper airway sample does not necessarily mean the same organis

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… Prophylactic options include TMP-SMX, atovaquone, dapsone, or pentamidine [ 75 ]. Invasive Fungal Infections High-risk patients, such as those who have undergone HSCT with severe GVHD, are typically placed on prophylaxis with posaconazole or voriconazole. …

Prevention and management of adverse events of novel agents in multiple myeloma: a consensus of the European Myeloma Network.

During the last few years, several new drugs have been introduced for treatment of patients with multiple myeloma, which have significantly improved the treatment outcome. All of these novel substances differ at least in part in their mode of action from similar drugs of the same drug class, or are representatives of new drug classes, and as such present with very specific side effect profiles. In this review, we summarize these adverse events, provide information on their prevention, and give practical guidance for monitoring of patients and for management of adverse events.

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… Other options are dapsone, atovaquone, or pentamidine [ 1 ]. Severe skin reactions Monitoring patients for severe skin reactions is recommended in patients receiving thalidomide, lenalidomide, pomalidomide, or ixazomib (Table S2A–D ). …

Оптимизация реального использования BCMA-Targeted T-Cell-Enging терапии у пациентов с тройным-классным рефлекторным/отредактированным множественным Myeloma: итальянский модифицированный Delphi Консенсус.

Площадь лечения повторной/рефракторной множественной миеломы (RRMM) значительно изменилась с внедрением новых классов агентов и, в последнее время, T-директивных методов лечения, включая биконкретные антитела (BSAbs). Существенно важно укрепить и согласовать терапевтическое управление БСА в рамках клинической практики. Мы провели модифицированное исследование экспертов Дельфи на основе консенсуса по вопросу об использовании BsAbs в целях борьбы с созреванием B-Cell (BCMA) у пациентов с тройным классом (TCE) RRMM. Исследование было проведено в апреле-ноябре 2025 в соответствии с установленными

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… before starting anti-BCMA BsAbs in TCE RRMM patients. 1 Degree of consensus was defined a priori as follows: majority consensus indicated agreement among 66.7–99.9% of panelists, whereas full consensus indicated unanimous agreement (100%). 2 In patients intolerant to trimethoprim–sulfamethoxazole, atovaquone …

Consensus Guidelines and Recommendations for The CD38 Monoclonal Antibody-based Quadruplet Therapy and Management in Clinical Practice for Newly Diagnosed Multiple Myeloma: From the Pan-Pacific Multiple Myeloma Working Group.

The therapeutic outcomes of clinical trials for incorporating anti-CD38 monoclonal antibodies (including isatuximab and daratumumab) into the bortezomib/lenalidomide/dexamethasone (VRd) triplet therapy backbone as the first-line treatment for newly diagnosed multiple myeloma (NDMM) have demonstrated significant improved efficacies. From a safety perspective, the addition of anti-CD38 monoclonal antibodies into the triplet therapies did not raise additional safety concerns. Based on the promising results, the National Comprehensive Cancer Network (NCCN) Guidelines Version 1.2025 had updated the

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… . • In cases where patients cannot tolerate this regimen, alternatives like atovaquone or dapsone may be considered. Vaccinations | • Vaccination is a critical component of infection prevention. …

FDA approved drugs with pharmacotherapeutic potential for SARS-CoV-2 (COVID-19) therapy.

In December 2019, a novel SARS-CoV-2 coronavirus emerged, causing an outbreak of life-threatening pneumonia in the Hubei province, China, and has now spread worldwide, causing a pandemic. The urgent need to control the disease, combined with the lack of specific and effective treatment modalities, call for the use of FDA-approved agents that have shown efficacy against similar pathogens. Chloroquine, remdesivir, lopinavir/ritonavir or ribavirin have all been successful in inhibiting SARS-CoV-2 in vitro. The initial results of a number of clinical trials involving various protocols of administr

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… compared to tocilizumab Anakinra | NCT04324021 | 54 | compared to emapalumab and standard treatment Angiotensin 1-7 | NCT04332666 | 60 | - ASC09 | NCT04261270 | 60 | compared to ritonavir; combined with oseltamivir ASC09 | NCT04261907 | 160 | compared to lopinavir/ritonavir; combined with ritonavir Atovaquone …

Infectious complications after hematopoietic stem cell transplantation: current status and future perspectives in Korea.

Hematopoietic stem cell transplantation (HSCT) is a treatment for hematologic malignancies, immune deficiencies, or genetic diseases, ect. Recently, the number of HSCTs performed in Korea has increased and the outcomes have improved. However, infectious complications account for most of the morbidity and mortality after HSCT. Post-HSCT infectious complications are usually classified according to the time after HSCT: pre-engraftment, immediate post-engraftment, and late post-engraftment period. In addition, the types and risk factors of infectious complications differ according to the stem cell

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… | | Atovaquone | 1,500 mg/day with fatty food; common toxicities include rash, headache and gastrointestinal disturbances. Autologous HSCT | 3–6 Months after HSCT | Same as allogeneic HSCT | CYTOMEGALOVIRUS CMV infection can occur after HSCT and can be fatal. …

Reactive oxygen species (ROS) in cancer: from mechanism to therapeutic implications.

Reactive oxygen species (ROS) act as critical secondary messengers in various intracellular signaling pathways that regulate cellular proliferation, differentiation, and survival under normal physiological conditions. However, dysregulation of redox signaling-driven by genetic mutations, epigenetic alterations, and posttranscriptional or posttranslational modifications-plays a central role in malignant transformation and cancer progression. Cancer cells typically exhibit elevated basal ROS levels due to increased metabolic activity, mitochondrial dysfunction, and oncogene activation. This mode