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

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 wor...

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Published in:Blood advances
Main Authors: VAN DOESUM, Jaap A., SALMANTON-GARCÍA, Jon, MARCHESI, Francesco, DI BLASI, Roberta, FALCES-ROMERO, Iker, CABIRTA, Alba, FARINA, Francesca, BESSON, Caroline, WEINBERGEROVÁ, Barbora, VAN PRAET, Jens, SCHÖNLEIN, Martin, LÓPEZ-GARCÍA, Alberto, LAMURE, Sylvain, GUIDETTI, Anna, RAMÓN-SÁNCHEZ, Cristina DE, BATINIĆ, Josip, GAVRIILAKI, Eleni, TRAGIANNIDIS, Athanasios, TISI, Maria Chiara, PLANTEFEVE, Gaëtan, PETZER, Verena, ORMAZABAL-VÉLEZ, Irati, ALMEIDA, Joyce MARQUES DE, MARCHETTI, Monia, MAERTENS, Johan, MACHADO, Marina, KULASEKARARAJ, Austin, HERNÁNDEZ-RIVAS, José-Ángel, GOMES DA SILVA, Maria, FERNÁNDEZ, Noemí, ESPIGADO, Ildefonso, DRGOŇA, Ľuboš, DRAGONETTI, Giulia, METAFUNI, Elisabetta, CALBACHO, Maria, BLENNOW, Ola, WOLF, Dominik, VAN ANROOIJ, Bjorn, NUNES RODRIGUES, Raquel, NORDLANDER, Anna, MARTÍN-GONZÁLEZ, Juan-Alberto, LIÉVIN, Raphaël, JIMÉNEZ, Moraima, GRÄFE, Stefanie K., GARCÍA-SANZ, Ramón, CÓRDOBA-MASCUÑANO, Raul, RAHIMLI, Laman, MEERTEN, Tom VAN, CORNELY, Oliver A., PAGANO, Livio
Format: Journal Article
Language:English
Published: by The American Society of Hematology 18-04-2023
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Summary: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.
Bibliography:contributed equally to this work
ISSN:2473-9529
2473-9537
DOI:10.1182/bloodadvances.2022009578