Why infections can happen after CAR-T 

Infections happen when harmful germs like bacteria or viruses enter the body and grow, making you sick.

After CAR T-cell therapy for myeloma, infections are more common because the treatment and inflammation can lower the number of blood cells that protect you from getting sick.

The most common infections after CAR-T for myeloma are viral and bacterial infections. Fungal infections are rare.

Symptoms to watch for

When your body is fighting an infection, you may notice signs like: 

These symptoms show that your body may be fighting an infection. Even mild signs like a sore throat or runny nose can be early warnings of something more serious. People with myeloma and their caregivers should tell the care team right away if any symptoms appear.

How infections are managed after CAR-T

Doctors may use several steps to lower the risk of infections after CAR-T. 

Preventive medicines. There are several medicines you may receive to help prevent infections.:

• Pneumonia: sulfamethoxazole and trimethoprim
• Bacterial infections: levofloxacin or moxifloxacin
• Viral infections: acyclovir, valacyclovir, or entecavir
• Low antibody levels: IVIG (immunoglobulin infusions) to support your immune system

Vaccines: To help rebuild protection from common viruses, your care team will recommend a revaccination schedule:

• Flu and COVID-19 vaccines (inactivated): Given 3 months after CAR-T
• Other inactivated vaccines: Given 6 months after CAR-T
• Non-live vaccines with immune boosters (adjuvants): Given 1 year after CAR-T if your immune system is strong enough

Talk to your doctor about when to get vaccines and what is right for your recovery. For more information about the revaccination schedule after CAR-T, click here.