COVID-19 大流行对肿瘤血液病患者的管理和护理产生了重大影响，特别是那些患有淋巴增殖性疾病的患者，他们患 COVID-19 相关细菌和真菌重复感染的风险较高。我们介绍了 44-一名 2 岁男性难治性套细胞淋巴瘤患者，尽管同时感染了 COVID-19，仍接受嵌合抗原受体 T (CAR-T) 细胞疗法治疗。患者出现II级细胞因子释放综合征，需要入住重症监护室。 CAR-T细胞有效扩增，患者实现了完全代谢缓解。在治疗过程中，患者出现了并发症，包括与 COVID-19 相关的肺曲霉病以及嗜麦芽寡养单胞菌和 SARS-CoV-2 omicron 变种的双重感染。及时的抗真菌和抗菌治疗以及适当的 COVID-19 治疗使这些感染得到了解决。还给予地塞米松以减轻炎症并帮助血液恢复。尽管存在多重感染，该患者还是实现了淋巴瘤的完全缓解，凸显了 CAR-T 细胞治疗在这名高危患者中的有效性。尽管并发感染带来了挑战，但还是决定继续进行 CAR-T 细胞治疗该患者被证明是成功的，淋巴瘤完全缓解。早期开始支持治疗和使用地塞米松有助于解决并发症。该病例强调了个体化决策的重要性以及 CAR-T 细胞治疗在类似高危患者中的潜在益处。© 2023 Radici, Giagulli, Accorsi Buttini, Farina, Polverelli, Brugnoni, Chiarini, Galvagni, Almici, Ferrari,比安切蒂、马斯内里、莱奥尼、雷、贝尔纳迪、马拉戈拉、雷、卡鲁索和鲁索。

The COVID-19 pandemic has had a significant impact on the management and care of onco-hematological patients, particularly those with lymphoproliferative disorders who are at higher risk for COVID-19 associated bacterial and fungal superinfections.We present the successful treatment of a 44-year-old male patient with refractory mantle cell lymphoma treated with chimeric antigen receptor T (CAR-T) cell therapy, despite concurrent COVID-19 infection. The patient developed grade II cytokine release syndrome, requiring admission to the intensive care unit. The CAR-T cells expanded effectively, and the patient achieved complete metabolic remission. During the treatment course, the patient experienced complications including COVID-19-associated pulmonary aspergillosis and a co-infection with Stenotrophomonas maltophilia and the SARS-CoV-2 omicron variant. Prompt antifungal and antibacterial therapy, along with appropriate COVID-19 treatment, led to the resolution of these infections. Dexamethasone was also administered to reduce inflammation and aid hematologic recovery. Despite the presence of multiple infections, the patient achieved complete remission of lymphoma, highlighting the effectiveness of CAR-T cell therapy in this high-risk patient.Despite the challenges posed by concurrent infections, the decision to proceed with CAR-T cell therapy in this patient proved to be successful, resulting in complete remission of lymphoma. Early initiation of supportive therapies and the use of dexamethasone contributed to the resolution of complications. This case underscores the importance of individualized decision-making and the potential benefits of CAR-T cell therapy in similar high-risk patients.© 2023 Radici, Giagulli, Accorsi Buttini, Farina, Polverelli, Brugnoni, Chiarini, Galvagni, Almici, Ferrari, Bianchetti, Masneri, Leoni, Re, Bernardi, Malagola, Re, Caruso and Russo.