General vaccination recommendations for adult patients receiving CAR T-cell therapy
| Vaccine . | Timing . | Comments . |
|---|---|---|
| Killed/inactivated vaccines | • ≥ 6 months after CAR T-cell infusion and ≥2 months since last immunoglobulin replacement therapy | • Contraindicated: ○ Actively receiving immunosuppressive agents ○ ≤6 months from receiving anti-CD19 or anti-BCMA therapy other than CAR-T cells ○ Actively receiving chemotherapy |
| Live and nonlive adjuvant vaccines | • ≥12 months after CAR T-cell infusion and ≥8 months since last immunoglobulin replacement therapy | • Contraindicated: ○ ≤12 months from receiving immunosuppressive agents ○ ≤12 months from receiving anti-CD19 or anti-BCMA therapy other than CAR-T cells ○ ≤12 months from receiving autologous HSCT ○ ≤24 months from receiving allogeneic HSCT ○ Actively receiving chemotherapy ○ CD4+ count ≤200 cells/mL |
| Influenza virus | • ≥3 months after CAR-T cell infusion | • Although high likelihood of lower vaccine response, the majority opinion is that vaccinations may still provide some protection |
| SARS-CoV-2 | • ≥3 months after CAR T-cell infusion | • Although antibody responses are poor, these is evidence that T-cell responses may be achieved |
| Vaccine . | Timing . | Comments . |
|---|---|---|
| Killed/inactivated vaccines | • ≥ 6 months after CAR T-cell infusion and ≥2 months since last immunoglobulin replacement therapy | • Contraindicated: ○ Actively receiving immunosuppressive agents ○ ≤6 months from receiving anti-CD19 or anti-BCMA therapy other than CAR-T cells ○ Actively receiving chemotherapy |
| Live and nonlive adjuvant vaccines | • ≥12 months after CAR T-cell infusion and ≥8 months since last immunoglobulin replacement therapy | • Contraindicated: ○ ≤12 months from receiving immunosuppressive agents ○ ≤12 months from receiving anti-CD19 or anti-BCMA therapy other than CAR-T cells ○ ≤12 months from receiving autologous HSCT ○ ≤24 months from receiving allogeneic HSCT ○ Actively receiving chemotherapy ○ CD4+ count ≤200 cells/mL |
| Influenza virus | • ≥3 months after CAR-T cell infusion | • Although high likelihood of lower vaccine response, the majority opinion is that vaccinations may still provide some protection |
| SARS-CoV-2 | • ≥3 months after CAR T-cell infusion | • Although antibody responses are poor, these is evidence that T-cell responses may be achieved |
Adapted from Hayden et al13 and Hill and Seo.20