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Case Report: Severe HHV-6-related encephalitis following anti-CD19 CAR-T therapy with no evidence of HHV-6 reactivation in transduced CAR-T cells

Year: 2025
Type: article
Study design: Case Report
Abstract: We report a case of severe encephalitis caused by human herpes virus 6 (HHV-6) following CD19 chimeric antigen receptor T (CAR-T) cell therapy. Rapid expansion of circulating T-lymphocytes and high HHV-6 viral load (4,500,000 DNA copies/mL) early after CAR-T infusion suggested HHV-6 transferal from autologous CAR-T cells. To investigate this hypothesis, we retrospectively analyzed cryo-preserved patient samples for HHV-6. HHV-6 was undetectable in the apheresis product, transduced CAR-T cells, and in vitro activated CAR-T cells. In conclusion, despite strong clinical suspicion, we found no evidence to substantiate the infused CAR-T cells as the source of the severe HHV-6 infection.
DOI: 10.3389/frhem.2025.1628552
Authors: Nina Marie Birk, Katrine Kielsen, Özcan Met, Eva Kannik Haastrup, Thomas M. Hulen, Cecilie Ø. Madsen, Torben Barington, Jonas Nielsen, Kristian Schønning, Søren Lykke Petersen, Marianne Ifversen
Institutions: Copenhagen University Hospital, Rigshospitalet, University of Copenhagen, Herlev Hospital, Technical University of Denmark, University of Southern Denmark, Odense University Hospital
Language: English
Subfield: Oncology
Field: Medicine
Open Access status: gold
Estimated APC paid: $2,353
Award: G186104510
OpenAlex ID: W4414365903
FWCI:
Cites: 35
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