An international multicenter study comparing COVID-19 omicron outcomes in patients with hematological malignancies treated with obinutuzumab versus rituximab.

Autor: Shafat T; Infectious Diseases Institute, Soroka University Medical Center, and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.; Clinical Research Center, Soroka University Medical Center, and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.; Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.; European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV), Basel, Switzerland., Grupel D; Department of Clinical Microbiology and Infectious Diseases, Hadassah Medical Center, Jerusalem, Israel.; Faculty of Medicine, Hebrew University, Jerusalem, Israel., Porges T; Hematology Department, Soroka University Medical Center, and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel., Abuhasira R; Clinical Research Center, Soroka University Medical Center, and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel., Belkin A; Internal Medicine D and Infectious Diseases Unit, Sheba Medical Center, Ramat-Gan, Israel.; Sackler Faculty of Medicine, Tel Aviv University, Ramat-Aviv, Israel., Deri O; Internal Medicine T, Sheba Medical Center, Ramat-Gan, Israel., Oster Y; Department of Clinical Microbiology and Infectious Diseases, Hadassah Medical Center, Jerusalem, Israel.; Faculty of Medicine, Hebrew University, Jerusalem, Israel., Zahran S; Department of Clinical Microbiology and Infectious Diseases, Hadassah Medical Center, Jerusalem, Israel.; Faculty of Medicine, Hebrew University, Jerusalem, Israel., Horwitz E; Department of Clinical Microbiology and Infectious Diseases, Hadassah Medical Center, Jerusalem, Israel.; Faculty of Medicine, Hebrew University, Jerusalem, Israel., Horowitz NA; Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel., Khatib H; Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel., Batista MV; European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV), Basel, Switzerland.; Department of Infectious Diseases, AC Camargo Cancer Center, São Paulo, São Paulo, Brazil., Cortez AC; Department of Hematology and Cell Therapy, AC Camargo Cancer Center, São Paulo, São Paulo, Brazil., Brosh-Nissimov T; Infectious Diseases Unit, Samson Assuta Ashdod University Hospital, Ashdod, Israel.; The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel., Segman Y; The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.; Hematology Institute, Samson Assuta Ashdod University Hospital, Ashdod, Israel., Ishay L; Rappaport Faculty of Medicine, Technion, Haifa, Israel.; Hillel Yaffe Medical Center, Hadera, Israel., Cohen R; Rappaport Faculty of Medicine, Technion, Haifa, Israel.; Hillel Yaffe Medical Center, Hadera, Israel., Atamna A; European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV), Basel, Switzerland.; Infectious Diseases Unit, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel., Spallone A; Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.; European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV), Basel, Switzerland., Chemaly RF; Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.; European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV), Basel, Switzerland., Ramos-Ramos JC; European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV), Basel, Switzerland.; Infectious Disease Unit, Internal Medicine Service. CIBERINFEC. Hospital Universitario La Paz, Madrid, Spain., Chowers M; Meir Medical Centre, Kfar Saba, Israel.; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Rogozin E; Infectious Diseases unit, Shamir (Assaf Harofeh) Medical Center, Be'er Ya'akov, Israel., Oren NC; Infectious Diseases unit, Shamir (Assaf Harofeh) Medical Center, Be'er Ya'akov, Israel., Keske Ş; European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV), Basel, Switzerland.; Department of Infectious Diseases, VKV American Hospital, Istanbul, Turkey., Barchad OW; Infectious Disease Unit, Shaare Zedek Medical Center, Jerusalem, Israel., Nesher L; Infectious Diseases Institute, Soroka University Medical Center, and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.; European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV), Basel, Switzerland.
Jazyk: angličtina
Zdroj: Cancer medicine [Cancer Med] 2024 Feb; Vol. 13 (3), pp. e6997.
DOI: 10.1002/cam4.6997
Abstrakt: Objectives: Hematological malignancy (HM) patients treated with anti-CD20 monoclonal antibodies are at higher risk for severe COVID-19. A previous single-center study showed worse outcomes in patients treated with obinutuzumab compared to rituximab. We examined this hypothesis in a large international multicenter cohort.
Methods: We included HM patients from 15 centers, from five countries treated with anti-CD20, comparing those treated with obinutuzumab (O-G) to rituximab (R-G) between December 2021 and June 2022, when Omicron lineage was dominant.
Results: We collected data on 1048 patients. Within the R-G (n = 762, 73%), 191 (25%) contracted COVID-19 compared to 103 (36%) in the O-G. COVID-19 patients in the O-G were younger (61 ± 11.7 vs. 64 ± 14.5, p = 0.039), had more indolent HM diagnosis (aggressive lymphoma: 3.9% vs. 67.0%, p < 0.001), and most were on maintenance therapy at COVID-19 diagnosis (63.0% vs. 16.8%, p < 0.001). Severe-critical COVID-19 occurred in 31.1% of patients in the O-G and 22.5% in the R-G. In multivariable analysis, O-G had a 2.08-fold increased risk for severe-critical COVID-19 compared to R-G (95% CI 1.13-3.84), adjusted for Charlson comorbidity index, sex, and tixagevimab/cilgavimab (T-C) prophylaxis. Further analysis comparing O-G to R-G demonstrated increased hospitalizations (51.5% vs. 35.6% p = 0.008), ICU admissions (12.6% vs. 5.8%, p = 0.042), but the nonsignificant difference in COVID-19-related mortality (n = 10, 9.7% vs. n = 12, 6.3%, p = 0.293).
Conclusions: Despite younger age and a more indolent HM diagnosis, patients receiving obinutuzumab had more severe COVID-19 outcomes than those receiving rituximab. Our findings underscore the need to evaluate the risk-benefit balance when considering obinutuzumab therapy for HM patients during respiratory viral outbreaks.
(© 2024 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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