TY - JOUR
T1 - Impact of SARS-CoV-2 vaccination and monoclonal antibodies on outcome post–CD19-directed CAR T-cell therapy: an EPICOVIDEHA survey
AU - Van Doesum, Jaap A.
AU - Salmanton-García, Jon
AU - Marchesi, Francesco
AU - Blasi, Roberta Di
AU - Falces-Romero, Iker
AU - Cabirta, Alba
AU - Farina, Francesca
AU - Besson, Caroline
AU - Weinbergerová, Barbora
AU - Van Praet, Jens
AU - Schönlein, Martin
AU - López-García, Alberto
AU - Lamure, Sylvain
AU - Guidetti, Anna
AU - De Ramón-Sánchez, Cristina
AU - Batinić, Josip
AU - Gavriilaki, Eleni
AU - Tragiannidis, Athanasios
AU - Tisi, Maria Chiara
AU - Plantefeve, Gaëtan
AU - Petzer, Verena
AU - Ormazabal-Vélez, Irati
AU - Almeida, Joyce Marques De
AU - Marchetti, Monia
AU - Maertens, Johan
AU - Machado, Marina
AU - Kulasekararaj, Austin
AU - Hernández-Rivas, José-Ángel
AU - Silva, Maria Gomes Da
AU - Fernández, Noemí
AU - Espigado, Ildefonso
AU - Drgoňa, Ľuboš
AU - Dragonetti, Giulia
AU - Metafuni, Elisabetta
AU - Calbacho, Maria
AU - Blennow, Ola
AU - Wolf, Dominik
AU - Van Anrooij, Bjorn
AU - Rodrigues, Raquel Nunes
AU - Nordlander, Anna
AU - Martín-González, Juan-Alberto
AU - Liévin, Raphaël
AU - Jiménez, Moraima
AU - Gräfe, Stefanie K.
AU - García-Sanz, Ramón
AU - Córdoba, Raúl
AU - Rahimli, Laman
AU - Van Meerten, Tom
AU - Cornely, Oliver A.
AU - Pagano, Livio
PY - 2023
Y1 - 2023
N2 - Patients with previous CD19-directed chimeric antigen receptor (CAR) T-cell therapy have a prolonged vulnerability to viral infections. Coronavirus disease 2019 (COVID-19) has a great impact and has previously been shown to cause high mortality in this population. Until now, real-world data on the impact of vaccination and treatment on patients with COVID-19 after CD19-directed CAR T-cell therapy are lacking. Therefore, this multicenter, retrospective study was conducted with data from the EPICOVIDEHA survey. Sixty-four patients were identified. The overall mortality caused by COVID-19 was 31%. Patients infected with the Omicron variant had a significantly lower risk of death due to COVID-19 compared with patients infected with previous variants (7% vs 58% [P = .012]). Twenty-six patients were vaccinated at the time of the COVID-19 diagnosis. Two vaccinations showed a marked but unsignificant reduction in the risk of COVID-19–caused mortality (33.3% vs 14.2% [P = .379]). In addition, the course of the disease appears milder with less frequent intensive care unit admissions (39% vs 14% [P = .054]) and a shorter duration of hospitalization (7 vs 27.5 days [P = .022]). Of the available treatment options, only monoclonal antibodies seemed to be effective at reducing mortality from 32% to 0% (P = .036). We conclude that survival rates of CAR T-cell recipients with COVID-19 improved over time and that the combination of prior vaccination and monoclonal antibody treatment significantly reduces their risk of death. This trial was registered at www.clinicaltrials.gov as #NCT04733729.
AB - Patients with previous CD19-directed chimeric antigen receptor (CAR) T-cell therapy have a prolonged vulnerability to viral infections. Coronavirus disease 2019 (COVID-19) has a great impact and has previously been shown to cause high mortality in this population. Until now, real-world data on the impact of vaccination and treatment on patients with COVID-19 after CD19-directed CAR T-cell therapy are lacking. Therefore, this multicenter, retrospective study was conducted with data from the EPICOVIDEHA survey. Sixty-four patients were identified. The overall mortality caused by COVID-19 was 31%. Patients infected with the Omicron variant had a significantly lower risk of death due to COVID-19 compared with patients infected with previous variants (7% vs 58% [P = .012]). Twenty-six patients were vaccinated at the time of the COVID-19 diagnosis. Two vaccinations showed a marked but unsignificant reduction in the risk of COVID-19–caused mortality (33.3% vs 14.2% [P = .379]). In addition, the course of the disease appears milder with less frequent intensive care unit admissions (39% vs 14% [P = .054]) and a shorter duration of hospitalization (7 vs 27.5 days [P = .022]). Of the available treatment options, only monoclonal antibodies seemed to be effective at reducing mortality from 32% to 0% (P = .036). We conclude that survival rates of CAR T-cell recipients with COVID-19 improved over time and that the combination of prior vaccination and monoclonal antibody treatment significantly reduces their risk of death. This trial was registered at www.clinicaltrials.gov as #NCT04733729.
KW - Use of monoclonal antibodies was effective in reducing attributable mortality
KW - still progression is milder with shorter hospitalization and ICU admission
KW - Vaccination did not improve COVID-19 attributed mortality
KW - Use of monoclonal antibodies was effective in reducing attributable mortality
KW - still progression is milder with shorter hospitalization and ICU admission
KW - Vaccination did not improve COVID-19 attributed mortality
UR - http://hdl.handle.net/10807/260262
U2 - 10.1182/bloodadvances.2022009578
DO - 10.1182/bloodadvances.2022009578
M3 - Article
SN - 2473-9529
VL - 7
SP - 2645
EP - 2655
JO - Blood advances
JF - Blood advances
ER -