Table 2.
Assessment and screening of infection risk before CAR-T therapy
| Tests | Contents | Patient status |
|---|---|---|
| General laboratory tests | ||
| CBC, hepatic and renal function, coagulation function, etc. | Hb, WBC, PLT, ALT, AST, ALB, TBIL, LDH, UREA, CREA, BUN, PT, TT, APTT, etc. | For all patients. |
|
Inflammatory indicators D-dimer, CRP, procalcitonin, serum ferritin, erythrocyte sedimentation rate, etc. Serum cytokines |
IL-2, IL-4, IL-6, IL-10, IL-17, TNF-α, INF-γ, etc. | For SARS-CoV-2 confirmed patients to assess the degree of infection. |
|
Immune indicators Lymphocyte subsets |
total T lymphocytes (CD3+), helper/inducer T lymphocytes (CD3+CD4+), suppressor/cytotoxic T lymphocytes (CD3+CD8+), B lymphocytes (CD3−CD19+), and natural killer cells (CD3−CD16+CD56+), etc. | For all patients to evaluate their immune status. |
| Etiological/serological detection | ||
| SARS-CoV-2 | nucleic acid and/or antigen detection | For all patients and repeated if necessary. |
| HBV | HBV-DNA, HBsAg, HBsAb, etc. | For all patients. |
| Other respiratory viruses | nucleic acid, antigen, or antibody detection (including influenza A or B, RSV, parainfluenza viruses, adenovirus, enterovirus, rhinovirus, etc.) |
When a respiratory tract co-infection is suspected. Note: It is difficult to distinguish COVID-19 from other respiratory virus infections based on symptoms alone. |
| Sputum cultures | The presence of sputum expectoration. | |
| G/GM test | For patients with high-risk factors for fungal infection. | |
| mNGS | Optional. An unbiased technology to detect a variety of pathogenic microorganisms. | |
| bronchoalveolar lavage fluid through a bronchoscope | SARS-CoV-2 nucleic acid | Advisable if chest CT imaging suggests residual shadow. |
| Imaging | ||
| Chest CT scans | For SARS-CoV-2 confirmed patients with pneumonia. | |
| Others | If other infection or organ dysfunction is suspected, the appropriate examinations can be performed. |
CBC, complete blood count; Hb, hemoglobin; WBC, white blood cell; PLT, platelet; ALT, alanine aminotransferase; AST, aspartate transaminase; ALB, albumin; TBIL, total bilirubin; LDH, lactate dehydrogenase; CREA, creatinine; UA, uric acid; BUN, blood urea nitrogen; PT, prothrombin time; TT, thrombin time; APTT, activated partial thromboplastin time; CRP, C-reactive protein; HBV, hepatitis B virus;HBsAg, hepatitis B surface antigen; HBsAb, hepatitis B surface antibody; RSV, respiratory syncytial virus; G/GM test, 1,3-β-D glucan test/galactomannan antigen test; mNGS, metagenomic next-generation sequencing