Patients with previous CD19 directed chimeric antigen receptor T cell therapy (CAR T)-cell therapy have a prolonged vulnerability to viral infections. Coronavirus diseases 2019 (COVID-19) has a great impact and has previously been shown to cause high mortality in this population. Until now, real world data of 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 to patients infected with previous variants (7% versus 58% (P=0.012)). Twenty-six patients were vaccinated at time of COVID-19 diagnosis. Two vaccinations showed marked but unsignificant reduction risk of COVID-19 caused mortality (33.3% versus 14.2% (P=0.379)).Also the course of disease appears milder with less frequent ICU admissions (39% versus 14% (P=0.054)) and shorter duration of hospitalization (7 versus 27.5 days (P=0.022)). Of the available treatment options, only monoclonal antibodies seemed to be effectively reducing mortality from 32% to zero (P=0.036). 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.

Impact of SARS-CoV-2 vaccination and monoclonal antibodies on outcome post CD19-CAR-T: an EPICOVIDEHA survey / J.A. van Doesum, J. Salmanton-García, F. Marchesi, R. Di Blasi, I. Falces-Romero, A. Cabirta, F. Farina, C. Besson, B. Weinbergerová, J. Van Praet, M. Schönlein, A. Lopez-Garcia, S. Lamure, A. Guidetti, C. De Ramón-Sánchez, J. Batinic, E. Gavriilaki, A. Tragiannidis, M.C. Tisi, G. Plantefeve, V. Petzer, I. Ormazabal-Velez, J. Marques de Almeida, M. Marchetti, J.A. Maertens, M. Machado, A.G. Kulasekararaj, J.Á. Hernández-Rivas, M. Gomes da Silva, N. Fernández, I. Espigado, L. Drgona, G. Dragonetti, E. Metafuni, M. Calbacho, O. Blennow, D. Wolf, B. van Anrooij, R. Nunes Rodrigues, A. Nordlander, J. Martín-González, R. Lievin, M. Jiménez, S.K. Grafe, R. Garcia-Sanz, R. Córdoba, L. Rahimli, T. van Meerten, O.A. Cornely, L. Pagano. - In: BLOOD ADVANCES. - ISSN 2473-9529. - (2023). [Epub ahead of print] [10.1182/bloodadvances.2022009578]

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

A. Guidetti;
2023

Abstract

Patients with previous CD19 directed chimeric antigen receptor T cell therapy (CAR T)-cell therapy have a prolonged vulnerability to viral infections. Coronavirus diseases 2019 (COVID-19) has a great impact and has previously been shown to cause high mortality in this population. Until now, real world data of 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 to patients infected with previous variants (7% versus 58% (P=0.012)). Twenty-six patients were vaccinated at time of COVID-19 diagnosis. Two vaccinations showed marked but unsignificant reduction risk of COVID-19 caused mortality (33.3% versus 14.2% (P=0.379)).Also the course of disease appears milder with less frequent ICU admissions (39% versus 14% (P=0.054)) and shorter duration of hospitalization (7 versus 27.5 days (P=0.022)). Of the available treatment options, only monoclonal antibodies seemed to be effectively reducing mortality from 32% to zero (P=0.036). 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.
Settore MED/15 - Malattie del Sangue
2023
14-apr-2023
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/970534
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