Advances in managing viral infections in allogeneic hematopoietic stem cell transplantation have contributed to improved patient outcomes. However, several unresolved challenges remain. This review will focus on the following key topics: 1) the current status of vaccines for preventing varicella-zoster virus infections, 2) the association between reactivation of cytomegalovirus and relapse rates of acute myeloid leukemia, 3) the impact of HHV-6B reactivation on the central nervous system, 4) cases of HHV-6B encephalitis following chimeric antigen receptor T-cell therapy and their clinical significance, and 5) the challenges in diagnosing post-transplant viral infections and efforts to improve detection rates using diagnostic methods such as multiplex PCR and next-generation sequencing. The review will discuss these insights and explore future perspectives.
We present a unique case of cervical edema-type Localized Cytokine Release Syndrome (L-CRS) following CAR T-cell therapy in an 80-year-old patient with diffuse large B-cell lymphoma (DLBCL). Despite tocilizumab’s typical efficacy in managing CRS, the patient’s L-CRS did not respond to tocilizumab but showed improvement with dexamethasone. The study emphasizes the rarity and potential severity of L-CRS, with only six similar cases reported previously. The observed variability in response to different treatments underscores the complexity of CRS manifestations, requiring tailored approaches for optimal management. This case contributes valuable insights into L-CRS, suggesting its potential manifestation independently of apparent cervical lesions and its differential response to tocilizumab and dexamethasone. Continued vigilance and exploration of management strategies are crucial in this evolving field.