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

Autor: 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 Lopez-Garcia, Sylvain Lamure, Anna Guidetti, Cristina De Ramón-Sánchez, Josip Batinic, Eleni Gavriilaki, Athanasios Tragiannidis, Maria Chiara Tisi, Gaëtan Plantefeve, Verena Petzer, Irati Ormazabal-Velez, Joyce Marques de Almeida, Monia Marchetti, Johan A. Maertens, Marina Machado, Austin G Kulasekararaj, José Ángel Hernández-Rivas, Maria Gomes da Silva, Noemí Fernández, Ildefonso Espigado, Lubos Drgona, Giulia Dragonetti, Elisabetta Metafuni, Maria Calbacho, Ola Blennow, Dominik Wolf, Bjorn van Anrooij, Raquel Nunes Rodrigues, Anna Nordlander, Juan-Alberto MARTÍN-GONZÁLEZ, Raphaël Lievin, Moraima Jiménez, Stefanie K Grafe, Ramon Garcia-Sanz, Raúl Córdoba, Laman Rahimli, Tom van Meerten, Oliver A Cornely, Livio Pagano
Rok vydání: 2023
Předmět:
Zdroj: Blood Advances.
ISSN: 2473-9537
2473-9529
DOI: 10.1182/bloodadvances.2022009578
Popis: 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.
Databáze: OpenAIRE
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