Impact of SARS-CoV-2 vaccination and monoclonal antibodies on outcome post–CD19-directed CAR T-cell therapy: an EPICOVIDEHA survey

Jaap A. Van Doesum, Jon Salmanton-García, Francesco Marchesi, Roberta Di Blasi, Iker Falces-Romero, Alba Cabirta, Francesca Farina, Caroline Besson, Barbora Weinbergerová, Jens Van Praet, Martin Schönlein, Alberto López-García, Sylvain Lamure, Anna Guidetti, Cristina De Ramón-Sánchez, Josip Batinić, Eleni Gavriilaki, Athanasios Tragiannidis, Maria Chiara Tisi, Gaëtan PlantefeveVerena Petzer, Irati Ormazabal-Vélez, Joyce Marques De Almeida, Monia Marchetti, Johan Maertens, Marina Machado, Austin Kulasekararaj, José-Ángel Hernández-Rivas, Maria Gomes Da Silva, Noemí Fernández, Ildefonso Espigado, Ľuboš Drgoňa, Giulia Dragonetti, Elisabetta Metafuni, Maria Calbacho, Ola Blennow, Dominik Wolf, Bjorn Van Anrooij, Raquel Nunes Rodrigues, Anna Nordlander, Juan-Alberto Martín-González, Raphaël Liévin, Moraima Jiménez, Stefanie K. Gräfe, Ramón García-Sanz, Raúl Córdoba, Laman Rahimli, Tom Van Meerten, Oliver A. Cornely, Livio Pagano

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

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.
Lingua originaleEnglish
pagine (da-a)2645-2655
Numero di pagine11
RivistaBlood advances
Volume7
DOI
Stato di pubblicazionePubblicato - 2023

Keywords

  • Use of monoclonal antibodies was effective in reducing attributable mortality
  • still progression is milder with shorter hospitalization and ICU admission
  • Vaccination did not improve COVID-19 attributed mortality

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