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Velasco Puyó P, Tagarro A, Garcia-Obregon S, Villate O, Moraleda C, Huerta Aragonés J, Bardón Cancho EJ, Faura Morros A, Galán-Gómez V, Escobar Fernández L, Lendinez-Molinos F, Herrero Velasco B, Ureña Horno L, Domínguez-Pinilla N, Pascual Gazquez JF, Nova Lozano C, Osuna-Marco M, Marín-Cruz I, Gomez Pastrana I, Garcia de Andoin Barandiaran N, Gallego Mingo N, Portugal Rodríguez R, Cañete A, Pareja León M, Castrillo Bustamante S, Tallón García M, Gónzalez-Prieto A, Solé-Rodríguez M, González Cruz M, Soriano-Arandes A, Mota M, Pérez-Hoyos S, Moreno L, Astigarraga I. Cancer is not a risk factor for severe COVID-19 in children, except in patients with recent allogeneic hematopoietic stem cell transplantation or comorbidities. Pediatr Blood Cancer 2024; 71:e31120. [PMID: 38825724 DOI: 10.1002/pbc.31120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/08/2024] [Accepted: 05/16/2024] [Indexed: 06/04/2024]
Abstract
The EPICO (Spanish general registry of COVID-19 in children)-SEHOP (Spanish Society of Pediatric Hematology and Oncology) platform gathers data from children with SARS-CoV-2 in Spain, allowing comparison between children with cancer or allogeneic hematopoietic stem cell transplantation (alloHSCT) and those without. The infection is milder in the cancer/alloHSCT group than in children without comorbidities (7.1% vs. 14.7%), except in children with recent alloHSCT (less than 300 days), of which 35.7% experienced severe COVID-19. These data have been shared with the SEHOP members to support treatment and isolation policies akin to those for children without cancer, except for those with recent alloHSCT or additional comorbidities. This highlights the collaborative registries potential in managing pandemic emergencies.
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Affiliation(s)
- Pablo Velasco Puyó
- Pediatric Oncology and Hematology Department, Vall d'Hebron Barcelona Hospital, Barcelona, Spain
| | - Alfredo Tagarro
- Fundación de Investigación Biomédica Hospital 12 de Octubre, Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain
- Department of Pediatrics, Infanta Sofía University Hospital, Fundación para la Investigación Biomédica e Innovación Hospital Universitario Infanta Sofía y Hospital del Henares (FIIB HUIS HHEN), Madrid, Spain
- Universidad Europea de Madrid, Madrid, Spain
| | - Susana Garcia-Obregon
- BioBizkaia Health Research Institute, Pediatric Oncology Group, Barakaldo, Spain
- UPV/EHU, Physiology Department, Universidad del País Vasco/Euskal Herriko Unibertsitatea, Leioa, Spain
| | - Olatz Villate
- BioBizkaia Health Research Institute, Pediatric Oncology Group, Barakaldo, Spain
| | - Cinta Moraleda
- Fundación de Investigación Biomédica Hospital 12 de Octubre, Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain
- Pediatric Infectious Disease Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Jorge Huerta Aragonés
- Paediatrics Department, Paediatric and Adolescent Haematology and Oncology Section, Hospital Materno-Infantil del Complejo Hospitalario General Universitario Gregorio Marañón, Madrid, Spain
- Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Eduardo J Bardón Cancho
- Paediatrics Department, Paediatric and Adolescent Haematology and Oncology Section, Hospital Materno-Infantil del Complejo Hospitalario General Universitario Gregorio Marañón, Madrid, Spain
- Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Anna Faura Morros
- Pediatric Oncology and Hematology Unit, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Víctor Galán-Gómez
- Pediatric Oncology and Hematology Department, Hospital Infantil Universitario La Paz, Madrid, Spain
| | - Laura Escobar Fernández
- Pediatric Oncology and Hematology Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | - Blanca Herrero Velasco
- Pediatric Oncology and Hematology Unit, Hospital Infantil Universitario del Niño Jesús, Madrid, Spain
| | | | - Nerea Domínguez-Pinilla
- Pediatric Oncology Unit, Complejo Hospitalario de Toledo, Toledo, Spain
- i+12 Research Institute, Hospital 12 de Octubre, Madrid, Spain
| | | | | | | | - Inés Marín-Cruz
- Paediatric Infectious Diseases, Rheumatology and Immunology Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain
- Congenital Alterations of Immunity Group, Infectious Diseases and Immune System Area, Instituto de Biomedicina de Sevilla, Sevilla, Spain
| | - Irene Gomez Pastrana
- Pediatric Infectious Disease Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Nagore Garcia de Andoin Barandiaran
- Pediatric Oncology and Hematology Unit, Donostia University Hospital, San Sebastián, Spain
- Biogipuzkoa Health Research Institute, Pediatric Group, Paseo Dr. Begiristain, San Sebastián, Spain
- UPV/EHU, Pediatric Department, Paseo Dr. J. Beguiristain, Universidad del País Vasco/Euskal Herriko Unibertsitatea, San Sebastian, Spain
| | | | | | - Adela Cañete
- Pediatric Oncology and Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Marta Pareja León
- Paediatrics Department, Hospital General de Albacete, Albacete, Spain
| | | | | | - Almudena Gónzalez-Prieto
- Pediatric Oncology and Hematology Department, Hospital Universitario de Salamanca, Salamanca, Spain
| | | | | | - Antonio Soriano-Arandes
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Hospital Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Miriam Mota
- Unit of Statistics and Bioinformatics (UEB), Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Santiago Pérez-Hoyos
- Unit of Statistics and Bioinformatics (UEB), Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Lucas Moreno
- Pediatric Oncology and Hematology Department, Vall d'Hebron Barcelona Hospital, Barcelona, Spain
| | - Itziar Astigarraga
- BioBizkaia Health Research Institute, Pediatric Oncology Group, Barakaldo, Spain
- Department of Pediatrics, Hospital Universitario Cruces, Barakaldo, Spain
- UPV/EHU, Department of Pediatrics, Universidad del País Vasco/Euskal Herriko Unibertsitatea, Barakaldo, Spain
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Lee YJ, Kim HK, Kim Y, Park SH, Lim JH, Jung J, Choi YS, Jo JC. Tixagevimab/cilgavimab (AZD7442/Evusheld) prevent from COVID19 in patients with hematologic malignancies under active chemotherapy. Ann Hematol 2024; 103:2533-2539. [PMID: 38678486 DOI: 10.1007/s00277-024-05769-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/19/2024] [Indexed: 05/01/2024]
Abstract
Despite the efficacy of COVID-19 vaccines, patients with hematologic malignancy may still be fatal from COVID19. Therefore, we prospectively performed the analysis of administration of tixagevimab/cilgavimab in the real-world. In August 2022, 94 patients under active chemotherapy for lymphoma, multiple myeloma, or acute leukemia received a single dose AZD7442/Evusheld (two consecutive intramuscular injections of tixagevimab and cilgavimab, 300 mg each). Quantitative measurement of anti-SARS-CoV-2 spike protein (anti-S) and viral nucleocapsid (anti-N) titers were conducted before administration of tixagevimab/cilgavimab and at 1, 3, and 6 months after administration. Twenty-five patients (26.6%) had previously confirmed COVID-19 infection. Fifty-eight patients (61.7%) had previously received COVID-19 vaccinations, with a median of two doses (range, 1-5). The median anti-S Ab level increased from baseline (997.05 AU/mL) to 1 month (20,967.25 AU/mL), then decreased at 3 months (13,145.0 AU/mL), and 6 months (7123.0 AU/mL) (p < 0.001). There was no significant safety issue with tixagevimab/cilgavimab. With a median follow-up time of 6 months, thirteen patients (13.8%) had documented SARS-Cov-2 infection. A 20.2% rate of anti-N positivity was observed six months after the administration of tixagevimab/cilgavimab. The results of this study support the potential role of tixagevimab/cilgavimab for the prevention of symptomatic and severe COVID-19.Trial registration: KCT0007617; August 16, 2022.
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Affiliation(s)
- Yoo Jin Lee
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Hyun-Ki Kim
- Department of Laboratory Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Youjin Kim
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Sang Hyuk Park
- Department of Laboratory Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Ji-Hun Lim
- Department of Laboratory Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Jiwon Jung
- Department of Infectious Disease, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yun-Suk Choi
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae-Cheol Jo
- Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
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3
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Hahn EH, Li H, Sauter CS, Mossad SB. Impact of COVID-19 monoclonal antibodies on outcomes of COVID-19 infection in hematopoietic stem cell transplant and chimeric antigen receptor therapy recipients. Transpl Infect Dis 2024:e14322. [PMID: 38937864 DOI: 10.1111/tid.14322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 05/16/2024] [Accepted: 06/05/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Hematopoietic stem cell transplant (HSCT) and chimeric antigen receptor T-cell therapy (CAR-T) recipients are at higher risk of serious complications of COVID-19 infection than the general population. Though there is evidence that monoclonal antibodies (MCA) against COVID-19 reduce the risk of death and hospitalization in the general population, data regarding their efficacy in HSCT and CAR-T recipients remains scarce. METHODS We conducted a retrospective review of HSCT and CAR-T recipients to compare 30-day outcomes between patients who did and did not receive MCA after their first episode of COVID-19 between May 1, 2020 and December 31, 2022. Outcomes were defined as the most severe complication experienced out of the following: 30-day emergency department visit, hospitalization, intensive care unit admission, and death after COVID-19 infection. RESULTS We identified 166 patients comprised of 53.6% allogeneic HSCT, 35.5% autologous HSCT, and 10.8% CAR-T recipients; 107 had received a COVID-19 vaccine >2 weeks prior to testing positive, and 40 were treated with MCA. After adjusting for age, presence of symptoms at the initial positive test, and COVID-19 vaccination status, patients who did not receive MCA were five times more likely to develop complications after COVID-19 infection (adjusted odds ratio 5.0 [95% CI, 1.9-12.8], p = .001). CONCLUSION HSCT and CAR-T recipients who received MCA following COVID-19 infection were far less likely to develop COVID-related complications than those who did not receive MCA, regardless of vaccination status. This underscores the potential benefit of developing novel MCA with efficacy against circulating COVID-19 strains.
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Affiliation(s)
- Elizabeth H Hahn
- Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Hong Li
- Department of Hematology and Oncology, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Craig S Sauter
- Department of Hematology and Oncology, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Sherif B Mossad
- Department of Infectious Disease, Cleveland Clinic Foundation, Cleveland, Ohio, USA
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4
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Lahmer T, Salmanton-García J, Marchesi F, El-Ashwah S, Nucci M, Besson C, Itri F, Jaksic O, Čolović N, Weinbergerová B, Seval GC, Adžić-Vukičević T, Szotkowski T, Sili U, Dargenio M, van Praet J, van Doesum J, Schönlein M, Ráčil Z, Žák P, Poulsen CB, Magliano G, Jiménez M, Bonuomo V, Piukovics K, Dragonetti G, Demirkan F, Blennow O, Valković T, Gomes Da Silva M, Maertens J, Glenthøj A, Fernández N, Bergantim R, Verga L, Petzer V, Omrani AS, Méndez GA, Machado M, Ledoux MP, Bailén R, Duarte RF, Del Principe MI, Farina F, Martín-Pérez S, Dávila-Valls J, Marchetti M, Bilgin YM, Fracchiolla NS, Cattaneo C, Espigado I, Cordoba R, Collins GP, Labrador J, Falces-Romero I, Prezioso L, Meers S, Passamonti F, Buquicchio C, López-García A, Kulasekararaj A, Ormazabal-Vélez I, Cuccaro A, Garcia-Vidal C, Busca A, Navrátil M, de Jonge N, Biernat MM, Guidetti A, Abu-Zeinah G, Samarkos M, Anastasopoulou A, de Ramón C, González-López TJ, Hoenigl M, Finizio O, Pinczés LI, Ali N, Vena A, Tascini C, Stojanoski Z, Merelli M, Emarah Z, Kohn M, Barać A, Mladenović M, Mišković B, Ilhan O, Çolak GM, Čerňan M, Gräfe SK, Ammatuna E, Hanakova M, Víšek B, Cabirta A, Nordlander A, Nunes Rodrigues R, Hersby DS, Zambrotta GPM, Wolf D, Núñez-Martín-Buitrago L, Arellano E, Aiello TF, García-Sanz R, Prattes J, Egger M, Limongelli A, Bavastro M, Cvetanoski M, Dibos M, Rasch S, Rahimli L, Cornely OA, Pagano L. Need for ICU and outcome of critically ill patients with COVID-19 and haematological malignancies: results from the EPICOVIDEHA survey. Infection 2024; 52:1125-1141. [PMID: 38388854 PMCID: PMC11143019 DOI: 10.1007/s15010-023-02169-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 12/23/2023] [Indexed: 02/24/2024]
Affiliation(s)
- Tobias Lahmer
- Medizinische Klinik II, Klinikum rechts der Isar, TU München, Munich, Germany
| | - Jon Salmanton-García
- Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Herderstraße 52-54, 50931, Cologne, Germany.
- Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Marcio Nucci
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Caroline Besson
- Centre Hospitalier de Versailles, Le Chesnay, France; Université Paris-Saclay, UVSQ, Inserm, Équipe "Exposome et Hérédité", CESP, Villejuif, France
| | - Federico Itri
- San Luigi Gonzaga Hospital - Orbassano, Orbassano, Italy
| | - Ozren Jaksic
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia
| | - Natasha Čolović
- University Clinical Center Serbia, Medical Faculty University Belgrade, Belgrade, Serbia
| | - Barbora Weinbergerová
- Department of Internal Medicine - Hematology and Oncology, Masaryk University Hospital Brno, Brno, Czech Republic
| | | | | | | | - Uluhan Sili
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Michelina Dargenio
- Hematology and Stem Cell Transplan Unit, Vito Fazzi Hospital, Lecce, Italy
| | - Jens van Praet
- Department of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | | | - Martin Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Zdeněk Ráčil
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Pavel Žák
- University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | | | | | - Moraima Jiménez
- Department of Hematology, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Valentina Bonuomo
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Klára Piukovics
- Department of Internal Medicine, South Division Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Giulia Dragonetti
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | - Fatih Demirkan
- Division of Hematology, Dokuz Eylul University, Izmir, Turkey
| | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Toni Valković
- University Hospital Centre Rijeka, Rijeka, Croatia
- Croatian Cooperative Group for Hematological Diseases (CROHEM), Faculty of Medicine and Faculty of Health Studies, University of Rijeka, Rijeka, Croatia
| | | | - Johan Maertens
- Department of Microbiology, Immunology, and Transplantation, KULeuven, Leuven and Department of Hematology, UZ Leuven, Louvain, Belgium
| | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Noemí Fernández
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Rui Bergantim
- Centro Hospitalar e Universitário São João, Porto, Portugal
| | - Luisa Verga
- Azienda Ospedaliera San Gerardo - Monza, Monza, Italy
- Università Milano-Bicocca, Milan, Italy
| | - Verena Petzer
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck (MUI), Innsbruck, Austria
| | - Ali S Omrani
- Communicable Disease Center, Hamad Medical Corporation, Doha, Qatar
| | | | - Marina Machado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Rebeca Bailén
- Hematology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | | | | | | | | - Monia Marchetti
- Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Yavuz M Bilgin
- Department of Internal Medicine, ADRZ, Goes, Netherlands
| | | | | | - Ildefonso Espigado
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS / CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | - Raul Cordoba
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Graham P Collins
- NIHR Oxford Biomedical Research Centre, Churchill Hospital, Oxford, UK
| | - Jorge Labrador
- Department of Hematology, Research Unit, Hospital Universitario de Burgos, Burgos, Spain
- Facultad de Ciencias de la Salud, Universidad Isabel I, Burgos, Spain
| | - Iker Falces-Romero
- La Paz University Hospital, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Lucia Prezioso
- Hospital University of Parma - Hematology and Bone Marrow Unit, Parma, Italy
| | | | - Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | | | - Alberto López-García
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | | | | | - Annarosa Cuccaro
- Hematology Unit, Center for Translational Medicine, Azienda USL Toscana NordOvest, Leghorn, Italy
| | | | - Alessandro Busca
- Stem Cell Transplant Center, AOU Citta' della Salute e della Scienza, Turin, Italy
| | - Milan Navrátil
- Head of the ICU and Transplant Unit, Department of Hematooncology, University Hospital of Ostrava, Ostrava-Poruba, Czech Republic
| | - Nick de Jonge
- Amsterdam UMC, location VUmc, Amsterdam, Netherlands
| | - Monika M Biernat
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Anna Guidetti
- University of Milan and Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Ghaith Abu-Zeinah
- Division of Hematology and Oncology, Weill Cornell Medicine, New York, USA
| | | | | | - Cristina de Ramón
- Hematology Department, Hospital Universitario de Salamanca, Salamanca, Spain
- IBSAL, Centro de Investigación del Cáncer-IBMCC (USAL-CSIC), Salamanca, Spain
| | | | - Martin Hoenigl
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- BioTechMed, Graz, Austria
| | | | - László Imre Pinczés
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | | | | | - Carlo Tascini
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | | | - Maria Merelli
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | - Ziad Emarah
- Oncology Center, Mansoura University, Mansoura, Egypt
| | - Milena Kohn
- Centre Hospitalier de Versailles, Versailles, France
| | - Aleksandra Barać
- Clinic for Infectious and Tropical Diseases, University Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Miloš Mladenović
- COVID hospital ""Batajnica"", Belgrade, Serbia
- Clinic for Orthopedic Surgery and Traumatology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Bojana Mišković
- Center for Radiology, University Clinical Center of Serbia, Belgrade, Serbia
| | | | - Gökçe Melis Çolak
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Martin Čerňan
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Stefanie K Gräfe
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Michaela Hanakova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Benjamín Víšek
- University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Alba Cabirta
- Department of Hematology, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Anna Nordlander
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | - Ditte Stampe Hersby
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | | | - Dominik Wolf
- Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Elena Arellano
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS / CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | | | - Ramón García-Sanz
- Head of Molecular Biology an HLA Unit, Department of Hematology, University Hospital of Salamanca (HUS/IBSAL/CIBERONC), Salamanca, Spain
| | | | - Matthias Egger
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | | | | | | | - Miriam Dibos
- Medizinische Klinik II, Klinikum rechts der Isar, TU München, Munich, Germany
| | - Sebastian Rasch
- Medizinische Klinik II, Klinikum rechts der Isar, TU München, Munich, Germany
| | - Laman Rahimli
- Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Herderstraße 52-54, 50931, Cologne, Germany
- Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany
| | - Oliver A Cornely
- Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Herderstraße 52-54, 50931, Cologne, Germany
- Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany
- Faculty of Medicine, and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), University of Cologne, Cologne, Germany
- Faculty of Medicine, and University Hospital Cologne, Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - Livio Pagano
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
- Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
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5
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Merli M, Costantini A, Tafuri S, Bavaro DF, Minoia C, Meli E, Luminari S, Gini G. Management of vaccinations in patients with non-Hodgkin lymphoma. Br J Haematol 2024; 204:1617-1634. [PMID: 38532527 DOI: 10.1111/bjh.19422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/07/2024] [Accepted: 03/13/2024] [Indexed: 03/28/2024]
Abstract
Vaccinations are fundamental tools in preventing infectious diseases, especially in immunocompromised patients like those affected by non-Hodgkin lymphomas (NHLs). The COVID-19 pandemic made clinicians increasingly aware of the importance of vaccinations in preventing potential life-threatening SARS-CoV-2-related complications in NHL patients. However, several studies have confirmed a significant reduction in vaccine-induced immune responses after anti-CD20 monoclonal antibody treatment, thus underscoring the need for refined immunization strategies in NHL patients. In this review, we summarize the existing data about COVID-19 and other vaccine's efficacy in patients with NHL and propose multidisciplinary team-based recommendations for the management of vaccines in this specific group of patients.
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Affiliation(s)
- Michele Merli
- Division of Hematology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Costantini
- Clinical Immunology Unit, Azienda Ospedaliero Universitaria delle Marche - Università Politecnica delle Marche, Ancona, Italy
| | - Silvio Tafuri
- Department of Biomedical Sciences and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Davide Fiore Bavaro
- Department of Biomedical Sciences and Human Oncology, Clinic of Infectious Diseases, Aldo Moro University of Bari, Bari, Italy
| | - Carla Minoia
- Hematology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Erika Meli
- Division of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Stefano Luminari
- Hematology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Surgical Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Guido Gini
- Clinic of Hematology, Azienda Ospedaliero Universitaria Delle Marche - Università Politecnica Delle Marche, Ancona, Italy
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6
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Salmanton-García J, Marchesi F, Farina F, Weinbergerová B, Itri F, Dávila-Valls J, Martín-Pérez S, Glenthøj A, Hersby DS, Gomes da Silva M, Nunes Rodrigues R, López-García A, Córdoba R, Bilgin YM, Falces-Romero I, El-Ashwah S, Emarah Z, Besson C, Kohn M, Van Doesum J, Ammatuna E, Marchetti M, Labrador J, Zambrotta GPM, Verga L, Jaksic O, Nucci M, Piukovics K, Cabirta-Touzón A, Jiménez M, Arellano E, Espigado I, Blennow O, Nordlander A, Meers S, van Praet J, Aiello TF, Garcia-Vidal C, Fracchiolla N, Sciumè M, Seval GC, Žák P, Buquicchio C, Tascini C, Gräfe SK, Schönlein M, Adžić-Vukičević T, Bonuomo V, Cattaneo C, Nizamuddin S, Čerňan M, Plantefeve G, Prin R, Szotkovski T, Collins GP, Dargenio M, Petzer V, Wolf D, Čolović N, Prezioso L, Valković T, Passamonti F, Méndez GA, Sili U, Vena A, Bavastro M, Limongelli A, Duarte RF, Ledoux MP, Cvetanoski M, Stojanoski Z, Machado M, Batinić J, Magliano G, Biernat MM, Pantić N, Poulsen CB, Cuccaro A, Del Principe MI, Kulasekararaj A, Ormazabal-Vélez I, Busca A, Demirkan F, Ijaz M, Klimko N, Stoma I, Khostelidi S, Fernández N, Omrani AS, Bergantim R, De Jonge N, Fouquet G, Navrátil M, Abu-Zeinah G, Samarkos M, Maertens J, De Ramón C, Guidetti A, Magyari F, González-López TJ, Lahmer T, Finizio O, Ali N, Pinczés LI, Lavilla-Rubira E, Romano A, Merelli M, Delia M, Calbacho M, Meletiadis J, Antić D, Hernández-Rivas JÁ, Marques de Almeida J, Al-Khabori M, Hoenigl M, Tisi MC, Khanna N, Barać A, Eisa N, Di Blasi R, Liévin R, Miranda-Castillo C, Bahr NC, Lamure S, Papa MV, Yahya A, Aujayeb A, Novák J, Erben N, Fernández-Galán M, Ribera-Santa Susana JM, Rinaldi I, Fazzi R, Piedimonte M, Duléry R, Gonzaga Y, Soto-Silva A, Sapienza G, Serris A, Drgoňa Ľ, Groh A, Serrano L, Gavriilaki E, Tragiannidis A, Prattes J, Coppola N, Otašević V, Mladenović M, Mitrović M, Mišković B, Jindra P, Zompi S, Sacchi MV, Krekeler C, Infante MS, García-Bordallo D, Çolak GM, Mayer J, Nygaard M, Hanáková M, Ráčil Z, Bonanni M, Koehler P, Rahimli L, Cornely OA, Pagano L. Decoding the historical tale: COVID-19 impact on haematological malignancy patients-EPICOVIDEHA insights from 2020 to 2022. EClinicalMedicine 2024; 71:102553. [PMID: 38533127 PMCID: PMC10963230 DOI: 10.1016/j.eclinm.2024.102553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/29/2024] [Accepted: 03/01/2024] [Indexed: 03/28/2024] Open
Abstract
Background The COVID-19 pandemic heightened risks for individuals with hematological malignancies due to compromised immune systems, leading to more severe outcomes and increased mortality. While interventions like vaccines, targeted antivirals, and monoclonal antibodies have been effective for the general population, their benefits for these patients may not be as pronounced. Methods The EPICOVIDEHA registry (National Clinical Trials Identifier, NCT04733729) gathers COVID-19 data from hematological malignancy patients since the pandemic's start worldwide. It spans various global locations, allowing comprehensive analysis over the first three years (2020-2022). Findings The EPICOVIDEHA registry collected data from January 2020 to December 2022, involving 8767 COVID-19 cases in hematological malignancy patients from 152 centers across 41 countries, with 42% being female. Over this period, there was a significant reduction in critical infections and an overall decrease in mortality from 29% to 4%. However, hospitalization, particularly in the ICU, remained associated with higher mortality rates. Factors contributing to increased mortality included age, multiple comorbidities, active malignancy at COVID-19 onset, pulmonary symptoms, and hospitalization. On the positive side, vaccination with one to two doses or three or more doses, as well as encountering COVID-19 in 2022, were associated with improved survival. Interpretation Patients with hematological malignancies still face elevated risks, despite reductions in critical infections and overall mortality rates over time. Hospitalization, especially in ICUs, remains a significant concern. The study underscores the importance of vaccination and the timing of COVID-19 exposure in 2022 for enhanced survival in this patient group. Ongoing monitoring and targeted interventions are essential to support this vulnerable population, emphasizing the critical role of timely diagnosis and prompt treatment in preventing severe COVID-19 cases. Funding Not applicable.
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Affiliation(s)
- Jon Salmanton-García
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Barbora Weinbergerová
- Masaryk University and University Hospital Brno - Department of Internal Medicine, Hematology and Oncology, Brno, Czech Republic
| | - Federico Itri
- San Luigi Gonzaga Hospital - Orbassano, Orbassano, Italy
| | | | | | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Ditte Stampe Hersby
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | | | | | - Alberto López-García
- Fundación Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Raúl Córdoba
- Fundación Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | | | - Iker Falces-Romero
- Microbiology and Parasitology Department, University Hospital La Paz, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Ziad Emarah
- Oncology Center, Mansoura University, Mansoura, Egypt
- King Abdullah Medical City, Makkah, Saudi Arabia
| | - Caroline Besson
- Centre Hospitalier de Versailles, Le Chesnay, France
- Université Paris-Saclay, UVSQ, Inserm, Équipe “Exposome et Hérédité”, CESP, Villejuif, France
| | - Milena Kohn
- Centre Hospitalier de Versailles, Le Chesnay, France
- Université Paris-Saclay, UVSQ, Inserm, Équipe “Exposome et Hérédité”, CESP, Villejuif, France
| | | | | | - Monia Marchetti
- Hematology and Transplant Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Jorge Labrador
- Department of Hematology, Research Unit, Hospital Universitario de Burgos, Burgos, Spain
| | | | - Luisa Verga
- Azienda Ospedaliera San Gerardo - Monza, Monza, Italy
- Università Milano-Bicocca, Milan, Italy
| | | | - Marcio Nucci
- Department of Internal Medicine, Federal University of Rio de Janeiro and Grupo Oncoclinicas, Rio de Janeiro, Brazil
| | - Klára Piukovics
- Department of Internal Medicine, South Division Faculty of Medicine University of Szeged, Szeged, Hungary
| | - Alba Cabirta-Touzón
- Department of Hematology, Vall d’Hebron Hospital Universitari, Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Moraima Jiménez
- Department of Hematology, Vall d’Hebron Hospital Universitari, Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Elena Arellano
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | - Ildefonso Espigado
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Nordlander
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | - Jens van Praet
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - Tommaso Francesco Aiello
- Department of Infectious Diseases, Hospital Clinic de Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Carolina Garcia-Vidal
- Department of Infectious Diseases, Hospital Clinic de Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Nicola Fracchiolla
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mariarita Sciumè
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Pavel Žák
- University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | | | - Carlo Tascini
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | | | - Martin Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | - Summiya Nizamuddin
- Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Martin Čerňan
- University Hospital Olomouc, Olomouc, Czech Republic
| | - Gaëtan Plantefeve
- Head ICU and CRC, Centre Hospitalier Victor DUPOUY, Argenteuil, France
| | - Romane Prin
- CRA from CRC Centre Hospitalier Victor DUPOUY, Argenteuil, France
| | | | | | | | - Verena Petzer
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck (MUI), Innsbruck, Austria
| | - Dominik Wolf
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck (MUI), Innsbruck, Austria
| | | | - Lucia Prezioso
- Hospital University of Parma - Hematology and Bone Marrow Unit, Parma, Italy
| | - Toni Valković
- University Hospital Centre Rijeka, Rijeka, Croatia
- Croatian Cooperative Group for Hematological Diseases (CROHEM), Croatia
- Faculty of Medicine and Faculty of Health Studies of University of Rijeka, Rijeka, Croatia
| | - Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | | | - Uluhan Sili
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | | | | | | | | | | | | | | | - Marina Machado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Josip Batinić
- Croatian Cooperative Group for Hematological Diseases (CROHEM), Croatia
- University Hospital Centre Zagreb, Zagreb, Croatia
- Faculty of Medicine University of Zagreb, Zagreb, Croatia
| | | | | | - Nikola Pantić
- University Clinical Center of Serbia, Belgrade, Serbia
| | | | - Annarosa Cuccaro
- Hematology Unit, Center for Translational Medicine, Azienda USL Toscana NordOvest, Livorno, Italy
- National Cancer Institute, Fondazione ‘G. Pascale’, IRCCS, Hematology-Oncology and Stem Cell Transplantation Unit, Naples, Italy
| | | | - Austin Kulasekararaj
- Department of Hematological Medicine, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | | | - Alessandro Busca
- Stem Cell Transplant Center, AOU Citta’ della Salute e della Scienza, Turin, Italy
| | - Fatih Demirkan
- Dokuz Eylul University, Division of Hematology, Izmir, Turkey
| | - Marriyam Ijaz
- Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Nikolai Klimko
- North-Western State Medical University Named after Iliá Ilich Méchnikov, Saint-Petersburg, Russia
| | - Igor Stoma
- Gomel State Medical University, Gomel, Belarus
| | - Sofya Khostelidi
- North-Western State Medical University Named after Iliá Ilich Méchnikov, Saint-Petersburg, Russia
| | - Noemí Fernández
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - Rui Bergantim
- Centro Hospitalar e Universitário São João, Porto, Portugal
| | - Nick De Jonge
- Amsterdam UMC, Location VUmc, Amsterdam, Netherlands
| | | | | | | | - Michail Samarkos
- Laikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Anna Guidetti
- University of Milan and Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Ferenc Magyari
- Division of Hematology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary
| | | | - Tobias Lahmer
- Medizinische Klinik II, Klinikum Rechts der Isar, TU München, Munich, Germany
| | | | | | - László Imre Pinczés
- Division of Hematology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary
| | | | | | - Maria Merelli
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | - Mario Delia
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy
| | | | - Joseph Meletiadis
- Clinical Microbiology Laboratory, Medical School, “Attikon” University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Darko Antić
- University Clinical Center of Serbia, Belgrade, Serbia
| | | | | | | | - Martin Hoenigl
- Division of Infectious Diseases, ECMM Excellence Center for Clinical Mycology, Department of Internal Medicine, Medical University of Graz, Austria
- BioTechMed, Graz, Austria
| | | | - Nina Khanna
- University Hospital of Basel, Basel, Switzerland
| | | | - Noha Eisa
- Aseer Central Hospital, Abha, Saudi Arabia
- Oncology Center Mansoura University, Mansoura, Egypt
| | | | | | | | - Nathan C. Bahr
- University of Kansas Medical Center, Kansas City, United States
| | - Sylvain Lamure
- Department of Clinical Hematology, Montpellier University Hospital, IGMM UMR5535 CNRS, University of Montpellier, Montpellier, France
| | | | - Ayel Yahya
- Aseer Central Hospital, Abha, Saudi Arabia
| | | | - Jan Novák
- University Hospital of Královské Vinohrady, Prague, Czech Republic
| | - Nurettin Erben
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine Eskisehir Osmangazi University, Eskisehir, Turkey
| | | | | | | | - Rita Fazzi
- Hematology and Stem Cell Transplant Unit, Osperadiela University Pisana Company, Pisa, Italy
| | | | - Rémy Duléry
- Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Inserm UMRs 938, Paris, France
| | - Yung Gonzaga
- Instituto Nacional do Cancer, Rio de Janeiro, Brazil
| | - Andrés Soto-Silva
- Faculty of Medicine, University of Chile. Infectious Diseases Unity, Salvador Hospital of Santiago, Santiago de Chile, Chile
| | - Giuseppe Sapienza
- Azienda Ospedaliera “Ospedali Riuniti Villa Sofia-Cervello”, Palermo, Italy
| | | | - Ľuboš Drgoňa
- Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Ana Groh
- Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Germany
| | | | - Eleni Gavriilaki
- General Hospital of Thessaloniki “George Papanikolaou”, Thessaloniki, Greece
| | | | | | - Nicola Coppola
- Department of Mental Health and Public Medicine, University of Campania, Naples, Italy
| | | | | | | | - Bojana Mišković
- Center for Radiology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Pavel Jindra
- University Hospital Pilsen, Pilsen, Czech Republic
| | - Sofia Zompi
- Stem Cell Transplant Center, AOU Citta’ della Salute e della Scienza, Turin, Italy
| | - Maria Vittoria Sacchi
- Hematology and Transplant Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Carolin Krekeler
- Department of Medicine A for Hematology, Oncology and Pneumology, University Hospital Münster, Münster, Germany
| | | | | | - Gökçe Melis Çolak
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Jiří Mayer
- Masaryk University and University Hospital Brno - Department of Internal Medicine, Hematology and Oncology, Brno, Czech Republic
| | | | - Michaela Hanáková
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
- Department of Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Zdeněk Ráčil
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
- Department of Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Matteo Bonanni
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
- Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Philipp Koehler
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Laman Rahimli
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Oliver A. Cornely
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany
| | - Livio Pagano
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
- Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
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7
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Zhu H, Lu X, Zhang X, Hua H, Zhang J, Miao Y, Gu W, Xu M, Lu X, Li B, Wang C, Ni H, Qian J, Shi J, Xu M, Wu G, Zhang Y, Shen Q, Wang Z, Zhu J, Cheng Z, Zhuang W, Lin G, Hu Y, Shan Q, Chen Y, Qiu H, Li J, Shi W. Multi-center study of COVID-19 infection in elderly patients with lymphoma: on behalf of Jiangsu Cooperative Lymphoma Group (JCLG). Ann Hematol 2024:10.1007/s00277-024-05744-6. [PMID: 38649594 DOI: 10.1007/s00277-024-05744-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
Elderly patients with lymphoproliferative diseases (LPD) are vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Here, we retrospectively described the clinical features and outcomes of the first time infection of Omicron SARS-CoV-2 in 364 elderly patients with lymphoma enrolled in Jiangsu Cooperative Lymphoma Group (JCLG) between November 2022 and April 2023 in China. Median age was 69 years (range 60-92). 54.4% (198/364) of patients were confirmed as severe and critical COVID-19 infection. In univariable analysis, Age > 70 years (OR 1.88, p = 0.003), with multiple comorbidities (OR 1.41, p = 0.005), aggressive lymphoma (OR 2.33, p < 0.001), active disease (progressive or relapsed/refractory, OR 2.02, p < 0.001), and active anti-lymphoma therapy (OR 1.90, p < 0.001) were associated with severe COVID-19. Multiple (three or more) lines of previous anti-lymphoma therapy (OR 3.84, p = 0.021) remained an adverse factor for severe COVID-19 in multivariable analysis. Moreover, CD20 antibody (Rituximab or Obinutuzumab)-based treatments within the last 6 months was associated with severe COVID-19 in the entire cohort (OR 3.42, p < 0.001). Continuous BTK inhibitors might be protective effect on the outcome of COVID-19 infection (OR 0.44, p = 0.043) in the indolent lymphoma cohort. Overall, 7.7% (28/364) of the patients ceased, multiple lines of previous anti-lymphoma therapy (OR 3.46, p = 0.016) remained an adverse factor for mortality.
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Affiliation(s)
- Huayuan Zhu
- Department of Hematology, Lymphoma Center, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China.
| | - Xiao Lu
- Department of Hematology, Lymphoma Center, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Xiaoping Zhang
- Department of Hematology, The Affiliated Zhongda Hospital of Southeast University Medical College, Nanjing, 210044, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Haiying Hua
- Department of Hematology, Wuxi Third People's Hospital, Wuxi, 214045, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Jie Zhang
- Department of Oncology, Affiliated Hospital of Nantong University, Nantong, 226001, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Yuqing Miao
- Department of Hematology, Yancheng First People's Hospital, Yancheng, 224006, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Weiying Gu
- Department of Hematology, The First People's Hospital of Changzhou and The Third Affiliated Hospital of Soochow University, Changzhou, 213004, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Min Xu
- Department of Hematology, Zhangjiagang First Affiliated Hospital of Soochow University, Zhangjiagang, 215699, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Xuzhang Lu
- Department of Hematology, Affiliated Changzhou Second Hospital of Nanjing Medical University, Changzhou, 213004, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Bingzong Li
- Department of Hematology, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Chunling Wang
- Department of Hematology, The First People's Hospital of Huai'an, Huai'an, 223399, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Haiwen Ni
- Department of Hematology, The Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, 210004, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Jun Qian
- Department of Hematology, Affiliated People's Hospital of Jiangsu University, Zhenjiang, 212002, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Jinning Shi
- Department of Hematology, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, 211199, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Maozhong Xu
- Department of Hematology, The Affiliated Jiangyin Hospital of Southeast University Medical College, Jiangyin, 214433, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Guangqi Wu
- Department of Hematology, The First People's Hospital of Suqian, Suqian, 223812, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Yunping Zhang
- Department of Hematology, The Affiliated Yixing Hospital of Jiangsu University, Yixing, 214206, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Qiudan Shen
- Department of Hematology, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, 215008, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Zhi Wang
- Department of Hematology, Wuxi Second People's Hospital, Wuxi, 214001, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Jianfeng Zhu
- Department of Hematology, The People's Hospital of Taizhou, Taizhou, 225399, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Zhen Cheng
- Department of Hematology, Taicang Hospital Affiliated to Soochow University, Taicang, 215488, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Wanchuan Zhuang
- Department of Hematology, The Second People's Hospital of Lianyungang, Lianyungang, 222002, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Guoqiang Lin
- Department of Hematology, Huai'an Hospital Affiliated to Xuzhou Medical College and Huai'an Second People's Hospital, Huai'an, 223022, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Yongjun Hu
- Department of Hematology, Huaiyin Hospital of Huai'an, Huai'an, 223399, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Qiurong Shan
- Department of Hematology, Shuyang Traditional Chinese Medicine Hospital, Shuyang, 223614, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Yifei Chen
- Department of Hematology, Jiangdu People's Hospital of Yangzhou, Yangzhou, 225202, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Hongchun Qiu
- Department of Hematology, The Third People's Hospital of Kunshan, Kunshan, 215316, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Jianyong Li
- Department of Hematology, Lymphoma Center, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China.
| | - Wenyu Shi
- Department of Oncology, Affiliated Hospital of Nantong University, Nantong, 226001, China.
- Department of Hematology, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, 226001, Jiangsu, China.
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China.
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8
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Ceolin C, De Rui M, Simonato C, Vergadoro M, Cazzavillan S, Acunto V, Papa MV, Trapella GS, Zanforlini BM, Curreri C, Bertocco A, Devita M, Coin A, Sergi G. Sarcopenic patients "get even": The impact of COVID-19 vaccination on mortality. Exp Gerontol 2024; 187:112382. [PMID: 38369251 DOI: 10.1016/j.exger.2024.112382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/06/2024] [Accepted: 02/15/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Coronavirus Disease-2019 (COVID-19), driven by the SARS-CoV-2 virus, has disproportionately affected the elderly, with comorbidities like sarcopenia worsening prognosis. Considering the significant impact of RNA vaccines on survival rates in this population, our objective is to investigate the impact of vaccination on the survival of hospitalized elderly patients with COVID-19, considering the presence or absence of sarcopenia. METHODS Prospective study conducted on 159 patients aged>65 years from September 2021 to March 2022. Data about clinical and body composition, and mortality at 12-months after discharge were recorded. Sarcopenia was diagnosed according to the 2019 European Consensus criteria. RESULTS At the twelfth month post-discharge, vaccinated sarcopenic individuals exhibited a mortality risk similar to vaccinated non-sarcopenic individuals, and lower than unvaccinated non-sarcopenic patients. Cox regression analysis, adjusted for age, gender, comorbidity, functional and vaccinal status, showed that the presence of sarcopenia did not significantly impact the risk of death within 12-months post-discharge. DISCUSSION Vaccination emerges as a protective measure for sarcopenic patients, countering the potential adverse effects of sarcopenia on COVID-19 outcomes, underscoring the importance of immunization in the frail elderly with a call for meticulous monitoring of its benefits. CONCLUSIONS Our study represents the first attempt to analyze the vaccine's effect on survival in sarcopenic hospitalized older adults with COVID-19. The administration of vaccination to sarcopenic patients proves pivotal, as its omission could lead to notably unfavorable outcomes within this specific population.
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Affiliation(s)
- Chiara Ceolin
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy.
| | - Marina De Rui
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy
| | - Cristina Simonato
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy
| | - Margherita Vergadoro
- Department of Medicine (DIMED), Department of Women's and Children's Health, University of Padua, Italy
| | - Sara Cazzavillan
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy
| | - Vittorio Acunto
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy
| | - Mario Virgilio Papa
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy
| | | | | | - Chiara Curreri
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy
| | - Anna Bertocco
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy
| | - Maria Devita
- Department of General Psychology (DPG), University of Padua, Italy
| | - Alessandra Coin
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy
| | - Giuseppe Sergi
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy
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9
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Saito M, Mori A, Ishio T, Kobayashi M, Tsukamoto S, Kajikawa S, Yokoyama E, Kanaya M, Izumiyama K, Muraki H, Morioka M, Kondo T. Initial Efficacy of the COVID-19 mRNA Vaccine Booster and Subsequent Breakthrough Omicron Variant Infection in Patients with B-Cell Non-Hodgkin's Lymphoma: A Single-Center Cohort Study. Viruses 2024; 16:328. [PMID: 38543695 PMCID: PMC10974858 DOI: 10.3390/v16030328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 02/17/2024] [Accepted: 02/18/2024] [Indexed: 05/23/2024] Open
Abstract
It has been suggested that the effect of coronavirus disease 2019 (COVID-19) booster vaccination in patients with B-cell non-Hodgkin's lymphoma (B-NHL) is inferior to that in healthy individuals. However, differences according to histological subtype or treatment status are unclear. In addition, there has been less research on patients who subsequently develop breakthrough infections. We investigated the effects of the first COVID-19 booster vaccination for patients with B-NHL and the clinical features of breakthrough infections in the Omicron variant era. In this study, B-NHL was classified into two histological subtypes: aggressive lymphoma and indolent lymphoma. Next, patients were subdivided according to treatment with anticancer drugs at the start of the first vaccination. We also examined the clinical characteristics and outcomes of patients who had breakthrough infections after a booster vaccination. The booster effect of the COVID-19 mRNA vaccine in patients with B-NHL varied considerably depending on treatment status at the initial vaccination. In the patient group at more than 1 year after the last anticancer drug treatment, regardless of the histological subtype, the booster effect was comparable to that in the healthy control group. In contrast, the booster effect was significantly poorer in the other patient groups. However, of the 213 patients who received the booster vaccine, 22 patients (10.3%) were infected with COVID-19, and 18 patients (81.8%) had mild disease; these cases included the patients who remained seronegative. Thus, we believe that booster vaccinations may help in reducing the severity of Omicron variant COVID-19 infection in patients with B-NHL.
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Affiliation(s)
- Makoto Saito
- Blood Disorders Center, Aiiku Hospital, Sapporo 064-0804, Hokkaido, Japan
| | - Akio Mori
- Blood Disorders Center, Aiiku Hospital, Sapporo 064-0804, Hokkaido, Japan
| | - Takashi Ishio
- Blood Disorders Center, Aiiku Hospital, Sapporo 064-0804, Hokkaido, Japan
| | - Mirei Kobayashi
- Blood Disorders Center, Aiiku Hospital, Sapporo 064-0804, Hokkaido, Japan
| | - Shihori Tsukamoto
- Blood Disorders Center, Aiiku Hospital, Sapporo 064-0804, Hokkaido, Japan
| | - Sayaka Kajikawa
- Blood Disorders Center, Aiiku Hospital, Sapporo 064-0804, Hokkaido, Japan
| | - Emi Yokoyama
- Blood Disorders Center, Aiiku Hospital, Sapporo 064-0804, Hokkaido, Japan
| | - Minoru Kanaya
- Blood Disorders Center, Aiiku Hospital, Sapporo 064-0804, Hokkaido, Japan
| | - Koh Izumiyama
- Blood Disorders Center, Aiiku Hospital, Sapporo 064-0804, Hokkaido, Japan
| | - Haruna Muraki
- Division of Laboratory, Aiiku Hospital, Sapporo 064-0804, Hokkaido, Japan
| | - Masanobu Morioka
- Blood Disorders Center, Aiiku Hospital, Sapporo 064-0804, Hokkaido, Japan
| | - Takeshi Kondo
- Blood Disorders Center, Aiiku Hospital, Sapporo 064-0804, Hokkaido, Japan
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10
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Anand ST, Vo AD, La J, Do NV, Fillmore NR, Brophy M, Branch-Elliman W, Monach PA. Severe COVID-19 in Vaccinated Adults With Hematologic Cancers in the Veterans Health Administration. JAMA Netw Open 2024; 7:e240288. [PMID: 38393725 PMCID: PMC10891464 DOI: 10.1001/jamanetworkopen.2024.0288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/04/2024] [Indexed: 02/25/2024] Open
Abstract
Importance With SARS-CoV-2 transforming into an endemic disease and with antiviral treatments available, it is important to establish which patients remain at risk of severe COVID-19 despite vaccination. Objective To quantify the associations of clinical and demographic variables with odds of severe COVID-19 among patients with hematologic cancers. Design, Setting, and Participants This case-control study included all patients with hematologic malignant neoplasms in the national Veterans Health Administration (VHA) who had documented SARS-CoV-2 infection after vaccination. Groups of patients with severe (cases) vs nonsevere (controls) COVID-19 were compared. Data were collected between January 1, 2020, and April 5, 2023, with data on infection collected between January 1, 2021, and September 30, 2022. All patients with diagnostic codes for hematologic malignant neoplasms who had documented vaccination followed by documented SARS-CoV-2 infection and for whom disease severity could be assessed were included. Data were analyzed from July 28 to December 30, 2023. Exposures Clinical (comorbidities, predominant viral variant, treatment for malignant neoplasm, booster vaccination, and antiviral treatment) and demographic (age and sex) variables shown in prior studies to be associated with higher or lower rates of severe COVID-19. Comorbidities included Alzheimer disease or dementia, chronic kidney disease, chronic obstructive pulmonary disease, diabetes, heart failure, and peripheral vascular disease. Main Outcome and Measures The main outcome was severe COVID-19 compared with nonsevere SARS-CoV-2 infection. Severe COVID-19 was defined as death within 28 days, mechanical ventilation, or hospitalization with use of dexamethasone or evidence of hypoxemia or use of supplemental oxygen. Multivariable logistic regression was used to estimate the associations of demographic and clinical variables with the odds of severe COVID-19, expressed as adjusted odds ratios (aORs) with 95% CIs. Results Among 6122 patients (5844 [95.5%] male, mean [SD] age, 70.89 [11.57] years), 1301 (21.3%) had severe COVID-19. Age (aOR per 1-year increase, 1.05; 95% CI, 1.04-1.06), treatment with antineoplastic or immune-suppressive drugs (eg, in combination with glucocorticoids: aOR, 2.32; 95% CI, 1.93-2.80), and comorbidities (aOR per comorbidity, 1.35; 95% CI, 1.29-1.43) were associated with higher odds of severe disease, whereas booster vaccination was associated with lower odds (aOR, 0.73; 95% CI, 0.62-0.86). After oral antiviral drugs became widely used in March 2022, 20 of 538 patients (3.7%) with SARS-CoV-2 infection during this period had progression to severe COVID-19. Conclusions and Relevance In this case-control study of patients with hematologic cancers, odds of severe COVID-19 remained high through mid-2022 despite vaccination, especially in patients requiring treatment.
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Affiliation(s)
- Sonia T. Anand
- VA Boston Cooperative Studies Program, Boston, Massachusetts
| | - Austin D. Vo
- VA Boston Cooperative Studies Program, Boston, Massachusetts
| | - Jennifer La
- VA Boston Cooperative Studies Program, Boston, Massachusetts
| | - Nhan V. Do
- VA Boston Cooperative Studies Program, Boston, Massachusetts
- Boston University School of Medicine, Boston, Massachusetts
- Department of Medicine, VA Boston Healthcare System, Boston, Massachusetts
| | - Nathanael R. Fillmore
- VA Boston Cooperative Studies Program, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Mary Brophy
- VA Boston Cooperative Studies Program, Boston, Massachusetts
- Boston University School of Medicine, Boston, Massachusetts
- Department of Medicine, VA Boston Healthcare System, Boston, Massachusetts
| | - Westyn Branch-Elliman
- VA Boston Cooperative Studies Program, Boston, Massachusetts
- Department of Medicine, VA Boston Healthcare System, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- VA Boston Center for Healthcare Organization and Implementation Research, Boston, Massachusetts
| | - Paul A. Monach
- VA Boston Cooperative Studies Program, Boston, Massachusetts
- Department of Medicine, VA Boston Healthcare System, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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11
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Kevličius L, Šablauskas K, Maneikis K, Juozapaitė D, Ringelevičiūtė U, Vaitekėnaitė V, Davainienė B, Daukėlaitė G, Vasilevska D, Stoškus M, Narkevičiūtė I, Sivickienė V, Rudaitis K, Minkauskas M, Naumovas D, Beinortas T, Griškevičius L. Immunogenicity and clinical effectiveness of mRNA vaccine booster against SARS-CoV-2 Omicron in patients with haematological malignancies: A national prospective cohort study. Br J Haematol 2024; 204:497-506. [PMID: 37786970 DOI: 10.1111/bjh.19126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/13/2023] [Accepted: 09/12/2023] [Indexed: 10/04/2023]
Abstract
Information regarding the protective anti-SARS-CoV-2 antibody levels and the effectiveness of the mRNA vaccines against the Omicron variant in patients with haematological malignancies is limited. We prospectively followed two times BNT162b2 vaccinated oncohaematological patients (n = 1010) without prior COVID-19 for PCR-confirmed breakthrough infections during the Alpha/Delta and the Omicron phases of the pandemic. Anti-S1-IgG levels were longitudinally monitored in patients who had received the third (booster) vaccine dose. Patients with anti-S1-IgG levels <50 BAU/mL 1 month after the booster had a higher risk of Omicron infections (RR 1.91; 95% CI 1.39-2.63; p = 0.0001) and severe infections (RR 8.74; 95% CI 3.99-19.1; p < 0.0001). Conversely, the risk of severe COVID-19 was <1% with anti-S1-IgG levels >500 BAU/mL and neutralizing antibody concentrations >50 U/mL. The risks of breakthrough Omicron infections (HR 0.55; 95% CI 0.32-0.96; p = 0.034) and severe COVID-19 (HR 0.27; 95% 0.11-0.7; p = 0.0074) were lower among patients who had received the booster dose. In conclusion, low antibody levels are associated with significantly increased risk of both the breakthrough Omicron infections and severe COVID-19. The third mRNA vaccine dose improved the protection against the Omicron and reduced the risk of severe disease.
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Affiliation(s)
- Lukas Kevličius
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
- Hematology and Oncology Department, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Karolis Šablauskas
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
- Hematology and Oncology Department, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Kazimieras Maneikis
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
- Hematology and Oncology Department, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Dovilė Juozapaitė
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Ugnė Ringelevičiūtė
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Vilmantė Vaitekėnaitė
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
- Hematology and Oncology Department, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Birutė Davainienė
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
- Hematology and Oncology Department, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Guoda Daukėlaitė
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
- Hematology and Oncology Department, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Dominika Vasilevska
- Hematology and Oncology Department, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Mindaugas Stoškus
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Ieva Narkevičiūtė
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Violeta Sivickienė
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Kęstutis Rudaitis
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Mantas Minkauskas
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Daniel Naumovas
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Tumas Beinortas
- Department of Haematology, Cambridge University Hospitals NHS trust, Cambridge, UK
- Wellcome-MRC Cambridge Stem Cell Institute, Cambridge, UK
| | - Laimonas Griškevičius
- Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
- Hematology and Oncology Department, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
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12
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Martínez-López J, de la Cruz J, Gil-Manso R, Yuste VJ, Aspa-Cilleruelo JM, Escobar CE, López-Jiménez J, Duarte R, Yerovi CJ, Hernández-Rivas JÁ, Herráez R, Quiroz-Cervantes K, Bustelos-Rodriguez R, Benavente C, Martínez Barranco P, Bastos Oteiro M, Alegre A, Pérez-Oteyza J, Ruiz E, Marcheco-Pupo EA, Cedillo Á, de Soto Álvarez T, García Ramirez P, Alonso Trillo R, Herrera P, Bengochea Casado ML, Arroyo Barea A, Martin De Bustamante JM, Ortiz J, Calbacho Robles M, García-Suárez J. COVID-19 Outcomes in Patients with Hematologic Malignancies in the Era of COVID-19 Vaccination and the Omicron Variant. Cancers (Basel) 2024; 16:379. [PMID: 38254867 PMCID: PMC10814951 DOI: 10.3390/cancers16020379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/02/2024] [Accepted: 01/06/2024] [Indexed: 01/24/2024] Open
Abstract
A greater understanding of clinical trends in COVID-19 outcomes among patients with hematologic malignancies (HM) over the course of the pandemic, particularly the Omicron era, is needed. This ongoing, observational, and registry-based study with prospective data collection evaluated COVID-19 clinical severity and mortality in 1818 adult HM patients diagnosed with COVID-19 between 27 February 2020 and 1 October 2022, at 31 centers in the Madrid region of Spain. Of these, 1281 (70.5%) and 537 (29.5%) were reported in the pre-Omicron and Omicron periods, respectively. Overall, patients aged ≥70 years (odds ratio 2.16, 95% CI 1.64-2.87), with >1 comorbidity (2.44, 1.85-3.21), or with an underlying HM of chronic lymphocytic leukemia (1.64, 1.19-2.27), had greater odds of severe/critical COVID-19; odds were lower during the Omicron BA.1/BA.2 (0.28, 0.2-0.37) or BA.4/BA.5 (0.13, 0.08-0.19) periods and among patients vaccinated with one or two (0.51, 0.34-0.75) or three or four (0.22, 0.16-0.29) doses. The hospitalization rate (75.3% [963/1279], 35.7% [191/535]), rate of intensive care admission (30.0% [289/963], 14.7% [28/191]), and mortality rate overall (31.9% [409/1281], 9.9% [53/536]) and in hospitalized patients (41.3% [398/963], 22.0% [42/191]) decreased from the pre-Omicron to Omicron period. Age ≥70 years was the only factor associated with higher mortality risk in both the pre-Omicron (hazard ratio 2.57, 95% CI 2.03-3.25) and Omicron (3.19, 95% CI 1.59-6.42) periods. Receipt of prior stem cell transplantation, COVID-19 vaccination(s), and treatment with nirmatrelvir/ritonavir or remdesivir were associated with greater survival rates. In conclusion, COVID-19 mortality in HM patients has decreased considerably in the Omicron period; however, mortality in hospitalized HM patients remains high. Specific studies should be undertaken to test new treatments and preventive interventions in HM patients.
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Affiliation(s)
- Joaquín Martínez-López
- Hematology Department, Hospital Universitario 12 de Octubre, imas12 Madrid, Universidad Complutense, CNIO-ISCIII, CIBERONC, 28041 Madrid, Spain
| | - Javier de la Cruz
- imas12 Research Institute, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - Rodrigo Gil-Manso
- Hematology Department, Hospital Universitario 12 de Octubre, imas12 Madrid, Universidad Complutense, CNIO-ISCIII, CIBERONC, 28041 Madrid, Spain
| | | | | | | | - Javier López-Jiménez
- Hematology Department, Hospital Universitario Ramón Y Cajal, 28034 Madrid, Spain
| | - Rafael Duarte
- Hematology Department, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Madrid, Spain
| | | | | | - Regina Herráez
- Hematology Department, Hospital Universitario Infanta Sofía, 28702 Madrid, Spain
| | | | | | - Celina Benavente
- Hematology Department, Hospital Clínico San Carlos, 28040 Madrid, Spain
| | | | - Mariana Bastos Oteiro
- Hematology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, 28009 Madrid, Spain
| | - Adrián Alegre
- Hematology Department, Hospital Universitario de La Princesa, IIS-HUP, 28006 Madrid, Spain
| | - Jaime Pérez-Oteyza
- Hematology Department, Hospital Universitario HM Sanchinarro, 28050 Madrid, Spain
| | - Elena Ruiz
- Hematology Department, Hospital Universitario del Tajo, 28300 Madrid, Spain
| | | | - Ángel Cedillo
- Asociación Madrileña de Hematología y Hemoterapia (AMHH), 28010 Madrid, Spain
| | | | | | | | - Pilar Herrera
- Hematology Department, Hospital Universitario Ramón Y Cajal, 28034 Madrid, Spain
| | | | - Andrés Arroyo Barea
- Hematology Department, Hospital Universitario 12 de Octubre, imas12 Madrid, Universidad Complutense, CNIO-ISCIII, CIBERONC, 28041 Madrid, Spain
| | | | - Javier Ortiz
- Hematology Department, Hospital Universitario de La Princesa, IIS-HUP, 28006 Madrid, Spain
| | - María Calbacho Robles
- Hematology Department, Hospital Universitario 12 de Octubre, imas12 Madrid, Universidad Complutense, CNIO-ISCIII, CIBERONC, 28041 Madrid, Spain
| | - Julio García-Suárez
- Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, 28805 Madrid, Spain
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13
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Enssle JC, Campe J, Moter A, Voit I, Gessner A, Yu W, Wolf S, Steffen B, Serve H, Bremm M, Huenecke S, Lohoff M, Vehreschild M, Rabenau HF, Widera M, Ciesek S, Oellerich T, Imkeller K, Rieger MA, von Metzler I, Ullrich E. Cytokine-responsive T- and NK-cells portray SARS-CoV-2 vaccine-responders and infection in multiple myeloma patients. Leukemia 2024; 38:168-180. [PMID: 38049509 PMCID: PMC10776400 DOI: 10.1038/s41375-023-02070-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 12/06/2023]
Abstract
Patients with multiple myeloma (MM) routinely receive mRNA-based vaccines to reduce COVID-19-related mortality. However, whether disease- and therapy-related alterations in immune cells and cytokine-responsiveness contribute to the observed heterogeneous vaccination responses is unclear. Thus, we analyzed peripheral blood mononuclear cells from patients with MM during and after SARS-CoV-2 vaccination and breakthrough infection (BTI) using combined whole-transcriptome and surface proteome single-cell profiling with functional serological and T-cell validation in 58 MM patients. Our results demonstrate that vaccine-responders showed a significant overrepresentation of cytotoxic CD4+ T- and mature CD38+ NK-cells expressing FAS+/TIM3+ with a robust cytokine-responsiveness, such as type-I-interferon-, IL-12- and TNF-α-mediated signaling. Patients with MM experiencing BTI developed strong serological and cellular responses and exhibited similar cytokine-responsive immune cell patterns as vaccine-responders. This study can expand our understanding of molecular and cellular patterns associated with immunization responses and may benefit the design of improved vaccination strategies in immunocompromised patients.
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Affiliation(s)
- Julius C Enssle
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Julia Campe
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- Goethe University Frankfurt, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany
- Goethe University Frankfurt, University Hospital, Department of Pediatrics, Frankfurt am Main, Germany
| | - Alina Moter
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- Goethe University Frankfurt, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany
- Goethe University Frankfurt, University Hospital, Department of Pediatrics, Frankfurt am Main, Germany
| | - Isabel Voit
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- Goethe University Frankfurt, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany
- Goethe University Frankfurt, University Hospital, Department of Pediatrics, Frankfurt am Main, Germany
| | - Alec Gessner
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Weijia Yu
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Sebastian Wolf
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Björn Steffen
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
| | - Hubert Serve
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Melanie Bremm
- Goethe University Frankfurt, University Hospital, Department of Pediatrics, Frankfurt am Main, Germany
| | - Sabine Huenecke
- Goethe University Frankfurt, University Hospital, Department of Pediatrics, Frankfurt am Main, Germany
| | - Michael Lohoff
- Institute of Medical Microbiology and Hospital Hygiene, Philipps University, Marburg, Germany
| | - Maria Vehreschild
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Infectious Diseases, Frankfurt am Main, Germany
| | - Holger F Rabenau
- Goethe University Frankfurt, University Hospital, Institute for Medical Virology, Frankfurt am Main, Germany
| | - Marek Widera
- Goethe University Frankfurt, University Hospital, Institute for Medical Virology, Frankfurt am Main, Germany
| | - Sandra Ciesek
- Goethe University Frankfurt, University Hospital, Institute for Medical Virology, Frankfurt am Main, Germany
- German Centre for Infection Research, external partner site, Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
| | - Thomas Oellerich
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Katharina Imkeller
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- Goethe University Frankfurt, University Hospital, Edinger Institute (Neurological Institute), Frankfurt am Main, Germany
- Goethe University Frankfurt, University Hospital, MSNZ Group of Computational Immunology, Frankfurt am Main, Germany
- University Cancer Center (UCT), Frankfurt am Main, Germany
| | - Michael A Rieger
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
- Cardio-Pulmonary Institute, Frankfurt am Main, Germany
| | - Ivana von Metzler
- Goethe University Frankfurt, University Hospital, Department of Medicine II - Hematology and Oncology, Frankfurt am Main, Germany
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Evelyn Ullrich
- Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany.
- German Cancer Consortium (DKTK), partner site Frankfurt/Mainz, a partnership between DKFZ and University Hospital Frankfurt, Frankfurt am Main, Germany.
- Goethe University Frankfurt, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany.
- Goethe University Frankfurt, University Hospital, Department of Pediatrics, Frankfurt am Main, Germany.
- University Cancer Center (UCT), Frankfurt am Main, Germany.
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14
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Musto P, Salmanton-García J, Sgherza N, Bergantim R, Farina F, Glenthøj A, Cengiz Seval G, Weinbergerová B, Bonuomo V, Bilgin YM, van Doesum J, Jaksic O, Víšek B, Falces-Romero I, Marchetti M, Dávila-Valls J, Martín-Pérez S, Nucci M, López-García A, Itri F, Buquicchio C, Verga L, Piukovics K, Navrátil M, Collins GP, Jiménez M, Fracchiolla NS, Labrador J, Prezioso L, Rossi E, Čolović N, Meers S, Kulasekararaj A, Cuccaro A, Blennow O, Valković T, Sili U, Ledoux MP, Batinić J, Passamonti F, Machado M, Duarte RF, Poulsen CB, Méndez GA, Espigado I, Demirkan F, Čerňan M, Cattaneo C, Petzer V, Magliano G, Garcia-Vidal C, El-Ashwah S, Gomes-Da-Silva M, Vena A, Ormazabal-Vélez I, van Praet J, Dargenio M, De-Ramón C, Del Principe MI, Marques-De-Almeida J, Wolf D, Szotkowski T, Obr A, Çolak GM, Nordlander A, Izuzquiza M, Cabirta A, Zambrotta GPM, Cordoba R, Žák P, Ammatuna E, Mayer J, Ilhan O, García-Sanz R, Quattrone M, Arellano E, Nunes-Rodrigues R, Emarah Z, Aiello TF, Hanakova M, Ráčil Z, Bavastro M, Limongelli A, Rahimli L, Marchesi F, Cornely OA, Pagano L. Survival in multiple myeloma and SARS-COV-2 infection through the COVID-19 pandemic: Results from the EPICOVIDEHA registry. Hematol Oncol 2024; 42:e3240. [PMID: 38050405 DOI: 10.1002/hon.3240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/17/2023] [Accepted: 11/02/2023] [Indexed: 12/06/2023]
Abstract
Patients affected by multiple myeloma (MM) have an increased risk of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection and subsequent coronavirus (20)19 disease (COVID-19)-related death. The changing epidemiological and therapeutic scenarios suggest that there has been an improvement in severity and survival of COVID-19 during the different waves of the pandemic in the general population, but this has not been investigated yet in MM patients. Here we analyzed a large cohort of 1221 patients with MM and confirmed SARS-CoV-2 infection observed between February 2020, and August 2022, in the EPICOVIDEHA registry from 132 centers around the world. Median follow-up was 52 days for the entire cohort and 83 days for survivors. Three-hundred and three patients died (24%) and COVID-19 was the primary reason for death of around 89% of them. Overall survival (OS) was significantly higher in vaccinated patients with both stable and active MM versus unvaccinated, while only a trend favoring vaccinated patients was observed in subjects with responsive MM. Vaccinated patients with at least 2 doses showed a better OS than those with one or no vaccine dose. Overall, according to pandemic waves, mortality rate decreased over time from 34% to 10%. In multivariable analysis, age, renal failure, active disease, hospital, and intensive care unit admission, were independently associated with a higher number of deaths, while a neutrophil count above 0.5 × 109 /L was found to be protective. This data suggests that MM patients remain at risk of SARS-CoV-2 infection even in the vaccination era, but their clinical outcome, in terms of OS, has progressively improved throughout the different viral phases of the pandemic.
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Affiliation(s)
- Pellegrino Musto
- Department of Precision and Regenerative Medicine and Ionian Area, "Aldo Moro" University School of Medicine, Bari, Italy
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy
| | - Jon Salmanton-García
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Nicola Sgherza
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy
| | - Rui Bergantim
- Centro Hospitalar e Universitário São João, Porto, Portugal
| | | | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | | | - Barbora Weinbergerová
- Department of Internal Medicine - Hematology and Oncology, Masaryk University Hospital Brno, Brno, Czech Republic
| | - Valentina Bonuomo
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Yavuz M Bilgin
- Department of Internal Medicine, ADRZ, Goes, Netherlands
| | | | - Ozren Jaksic
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia
| | - Benjamín Víšek
- University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Iker Falces-Romero
- La Paz University Hospital, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Monia Marchetti
- Azienda Ospedaliera Nazionale SS, Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | | | - Marcio Nucci
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alberto López-García
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Federico Itri
- San Luigi Gonzaga Hospital - Orbassano, Orbassano, Italy
| | | | - Luisa Verga
- Azienda Ospedaliera San Gerardo - Monza, Monza, Italy
- Università Milano-Bicocca, Milan, Italy
| | - Klára Piukovics
- Department of Internal Medicine, South Division Faculty of Medicine University of Szeged, Szeged, Hungary
| | - Milan Navrátil
- Head of the ICU and Transplant Unit, Department of Hematooncology, University Hospital of Ostrava, Ostrava-Poruba, Czech Republic
| | - Graham P Collins
- NIHR Oxford Biomedical Research Centre, Churchill Hospital, Oxford, UK
| | - Moraima Jiménez
- Department of Hematology, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | | | - Jorge Labrador
- Department of Hematology, Research Unit, Hospital Universitario de Burgos, Burgos, Spain
| | - Lucia Prezioso
- Hospital University of Parma - Hematology and Bone Marrow Unit, Parma, Italy
| | - Elena Rossi
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | - Natasha Čolović
- University Clinical Center Serbia, Medical Faculty University Belgrade, Belgrade, Serbia
| | | | | | - Annarosa Cuccaro
- Hematology Unit, Center for Translational Medicine, Azienda USL Toscana NordOvest, Livorno, Italy
| | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Toni Valković
- University Hospital Centre Rijeka, Rijeka, Croatia
- Croatian Cooperative Group for Hematological Diseases (CROHEM), Faculty of Medicine and Faculty of Health Studies University of Rijeka, Rijeka, Croatia
| | - Uluhan Sili
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | | | - Josip Batinić
- University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine University of Zagreb, Zagreb, Croatia
| | - Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Marina Machado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | | | | - Ildefonso Espigado
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS / CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | - Fatih Demirkan
- Division of Hematology, Dokuz Eylul University, Izmir, Turkey
| | - Martin Čerňan
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | | | - Verena Petzer
- Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | | | | | | | | | - Antonio Vena
- Clinica Malattie Infettive. Ospedale Policlinico San Martino - IRCCS, Genoa, Italy
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Jens van Praet
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | | | - Cristina De-Ramón
- Hematology Department, Hospital Universitario de Salamanca, Salamanca, Spain
- IBSAL, Centro de Investigación del Cáncer-IBMCC (USAL-CSIC), Salamanca, Spain
| | | | | | - Dominik Wolf
- Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Aleš Obr
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Gökçe Melis Çolak
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Anna Nordlander
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Macarena Izuzquiza
- Department of Hematology, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Alba Cabirta
- Department of Hematology, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | | | - Raul Cordoba
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Pavel Žák
- University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | | | - Jiří Mayer
- Department of Internal Medicine - Hematology and Oncology, Masaryk University Hospital Brno, Brno, Czech Republic
| | | | - Ramón García-Sanz
- IBSAL, Centro de Investigación del Cáncer-IBMCC (USAL-CSIC), Salamanca, Spain
- Head of Molecular Biology an HLA Unit, Department of Hematology, University Hospital of Salamanca (HUS/IBSAL/CIBERONC), Salamanca, Spain
| | - Martina Quattrone
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | - Elena Arellano
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS / CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | | | - Ziad Emarah
- Oncology Center, Mansoura University, Mansoura, Egypt
| | | | - Michaela Hanakova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Zdeněk Ráčil
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Martina Bavastro
- Clinica Malattie Infettive. Ospedale Policlinico San Martino - IRCCS, Genoa, Italy
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Alessandro Limongelli
- Clinica Malattie Infettive. Ospedale Policlinico San Martino - IRCCS, Genoa, Italy
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Laman Rahimli
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Oliver A Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Molecular Medicine Cologne (CMMC), Cologne, Germany
| | - Livio Pagano
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
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15
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Galli E, Di Rocco A, Pansini I, Frondizi F, Di Palma M, Metafuni E, Piccirillo N, Bianchi M, Cingolani A, Torelli GF, Hohaus S, Chiusolo P, Iori AP, Sica S, Martelli M, Sorà F. Impact of SARS-CoV-2 vaccination and passive prophylaxis with tixagevimab/cilgavimab on CAR-T patients: a three-year regional experience from the Italian covid pandemic. Bone Marrow Transplant 2023; 58:1394-1396. [PMID: 37666956 DOI: 10.1038/s41409-023-02093-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/02/2023] [Accepted: 08/17/2023] [Indexed: 09/06/2023]
Affiliation(s)
- Eugenio Galli
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alice Di Rocco
- Dipartimento di Medicina Traslazionale e di Precisione, Università di Roma Sapienza, Rome, Italy
| | - Ilaria Pansini
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Federico Frondizi
- Dipartimento di Sicurezza e Bioetica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Martina Di Palma
- Dipartimento di Medicina Traslazionale e di Precisione, Università di Roma Sapienza, Rome, Italy
| | - Elisabetta Metafuni
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Nicola Piccirillo
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Bianchi
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonella Cingolani
- Dipartimento di Sicurezza e Bioetica, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Stefan Hohaus
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Patrizia Chiusolo
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Anna Paola Iori
- Dipartimento di Medicina Traslazionale e di Precisione, Università di Roma Sapienza, Rome, Italy
| | - Simona Sica
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Maurizio Martelli
- Dipartimento di Medicina Traslazionale e di Precisione, Università di Roma Sapienza, Rome, Italy
| | - Federica Sorà
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
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16
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Kawashima I, Hyuga H, Nakadate A, Matsuura M, Sakamoto Y, Suzuki J, Kumagai T, Suzuki M, Koshiishi M, Yamamoto T, Nakajima K, Tanaka M, Kirito K. Pre-exposure prophylaxis with tixagevimab/cilgavimab for coronavirus disease 2019 (COVID-19) during the Omicron BA.5 wave at a single institution in Japan. Int J Hematol 2023; 118:731-736. [PMID: 37747583 DOI: 10.1007/s12185-023-03663-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 09/01/2023] [Accepted: 09/11/2023] [Indexed: 09/26/2023]
Abstract
Pre-exposure prophylaxis with tixagevimab/cilgavimab was considered a useful strategy to protect immunocompromised patients from COVID-19 based on the phase 3 PROVENT trial conducted between November 2020 and March 2021. However, after late 2021, the dominant substrains of COVID-19 changed to Omicron substrains, which showed resistance to tixagevimab/cilgavimab. Therefore, it is important to re-evaluate the real-world efficacy of tixagevimab/cilgavimab for the prevention of COVID-19 in the Omicron era. To this end, we retrospectively evaluated the efficacy and safety of tixagevimab/cilgavimab prophylaxis for COVID-19 during the Omicron BA.5 wave in Japan. A total of 240 consecutive patients with hematologic malignancies received tixagevimab/cilgavimab at our institution from October 18, 2022, to January 31, 2023. Among them, the cumulative incidence of COVID-19 at 90 days was 6.4%. A total of 10/14 (71.4%) had mild infection, and 4/14 (28.5%) had severe infection. No patient died due to COVID-19. Adverse events consisted of deep vein thrombosis in 2 patients. Our analysis indicated that pre-exposure prophylaxis with tixagevimab/cilgavimab might have clinical effectiveness in reducing the severity of COVID-19 in Japanese HM patients, even in the Omicron BA.5 surge. It also suggested that tixagevimab/cilgavimab may be associated with cardiovascular complications.
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Affiliation(s)
- Ichiro Kawashima
- Department of Hematology and Oncology, University of Yamanashi, 1110, Shimokato, Chuo-City, Yamanashi-Ken, 409-3898, Japan
| | - Hideto Hyuga
- Department of Hematology and Oncology, University of Yamanashi, 1110, Shimokato, Chuo-City, Yamanashi-Ken, 409-3898, Japan
| | - Ayato Nakadate
- Department of Hematology and Oncology, University of Yamanashi, 1110, Shimokato, Chuo-City, Yamanashi-Ken, 409-3898, Japan
| | - Minori Matsuura
- Department of Hematology and Oncology, University of Yamanashi, 1110, Shimokato, Chuo-City, Yamanashi-Ken, 409-3898, Japan
| | - Yuma Sakamoto
- Department of Hematology and Oncology, University of Yamanashi, 1110, Shimokato, Chuo-City, Yamanashi-Ken, 409-3898, Japan
| | - Jun Suzuki
- Department of Hematology and Oncology, University of Yamanashi, 1110, Shimokato, Chuo-City, Yamanashi-Ken, 409-3898, Japan
| | - Takuma Kumagai
- Department of Hematology and Oncology, University of Yamanashi, 1110, Shimokato, Chuo-City, Yamanashi-Ken, 409-3898, Japan
| | - Megumi Suzuki
- Department of Hematology and Oncology, University of Yamanashi, 1110, Shimokato, Chuo-City, Yamanashi-Ken, 409-3898, Japan
| | - Megumi Koshiishi
- Department of Hematology and Oncology, University of Yamanashi, 1110, Shimokato, Chuo-City, Yamanashi-Ken, 409-3898, Japan
| | - Takeo Yamamoto
- Department of Hematology and Oncology, University of Yamanashi, 1110, Shimokato, Chuo-City, Yamanashi-Ken, 409-3898, Japan
| | - Kei Nakajima
- Department of Hematology and Oncology, University of Yamanashi, 1110, Shimokato, Chuo-City, Yamanashi-Ken, 409-3898, Japan
| | - Masaru Tanaka
- Department of Hematology and Oncology, University of Yamanashi, 1110, Shimokato, Chuo-City, Yamanashi-Ken, 409-3898, Japan
| | - Keita Kirito
- Department of Hematology and Oncology, University of Yamanashi, 1110, Shimokato, Chuo-City, Yamanashi-Ken, 409-3898, Japan.
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17
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Rossi G, Salmanton-García J, Cattaneo C, Marchesi F, Dávila-Valls J, Martín-Pérez S, Itri F, López-García A, Glenthøj A, Gomes da Silva M, Besson C, Marchetti M, Weinbergerová B, Jaksic O, Jiménez M, Bilgin YM, Van Doesum J, Farina F, Žák P, Verga L, Collins GP, Bonuomo V, Van Praet J, Nucci M, Meers S, Espigado I, Fracchiolla NS, Valković T, Poulsen CB, Čolović N, Dragonetti G, Ledoux MP, Tascini C, Buquicchio C, Blennow O, Passamonti F, Machado M, Labrador J, Duarte RF, Schönlein M, Prezioso L, Falces-Romero I, Kulasekararaj A, Garcia-Vidal C, Fernández N, Abu-Zeinah G, Ormazabal-Vélez I, Adžić-Vukičević T, Piukovics K, Stoma I, Cuccaro A, Magliano G, Szotkowski T, González-López TJ, El-Ashwah S, Bergantim R, Sili U, Maertens J, Demirkan F, De Ramón C, Petzer V, Del Principe MI, Navrátil M, Dargenio M, Seval GC, Samarkos M, Ráčil Z, Pinczés LI, Lahmer T, Busca A, Méndez GA, Vena A, Biernat MM, Merelli M, Calbacho M, Barać A, Bavastro M, Limongelli A, Ilhan O, Wolf D, Çolak GM, García-Sanz R, Emarah Z, Mišković B, Gräfe SK, Mladenović M, Aiello TF, Núñez-Martín-Buitrago L, Nordlander A, Arellano E, Zambrotta GPM, Ammatuna E, Cabirta A, Sacchi MV, Nunes Rodrigues R, Hersby DS, Hanakova M, Rahimli L, Cordoba R, Cornely OA, Pagano L. Age, successive waves, immunization, and mortality in elderly COVID-19 hematological patients: EPICOVIDEHA findings. Int J Infect Dis 2023; 137:98-110. [PMID: 37863310 DOI: 10.1016/j.ijid.2023.10.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/16/2023] [Accepted: 10/13/2023] [Indexed: 10/22/2023] Open
Abstract
OBJECTIVES Elderly patients with hematologic malignancies face the highest risk of severe COVID-19 outcomes. The infection's impact on different age groups remains unstudied in detail. METHODS We analyzed elderly patients (age groups: 65-70, 71-75, 76-80, and >80 years old) with hematologic malignancies included in the EPICOVIDEHA registry between January 2020 and July 2022. Univariable and multivariable Cox regression models were conducted to identify factors influencing death in COVID-19 patients with hematological malignancy. RESULTS The study included data from 3,603 elderly patients (aged 65 or older) with hematological malignancy, with a majority being male (58.1%) and a significant proportion having comorbidities. The patients were divided into four age groups, and the analysis assessed COVID-19 outcomes, vaccination status, and other variables in relation to age and pandemic waves. The 90-day survival rate for patients with COVID-19 was 71.2%, with significant differences between groups. The pandemic waves had varying impacts, with the first wave affecting patients over 80 years old, the second being more severe in 65-70, and the third being the least severe in all age groups. Factors contributing to 90-day mortality included age, comorbidities, lymphopenia, active malignancy, acute leukemia, less than three vaccine doses, severe COVID-19, and using only corticosteroids as treatment. CONCLUSION These data underscore the heterogeneity of elderly hematological patients, highlight the different impacts of COVID-19 waves and the pivotal importance of vaccination, and may help in planning future healthcare efforts.
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Affiliation(s)
| | - Jon Salmanton-García
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
| | | | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | | | - Federico Itri
- San Luigi Gonzaga Hospital - Orbassano, Orbassano, Italy
| | - Alberto López-García
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | | | - Caroline Besson
- Centre Hospitalier de Versailles, Le Chesnay, France; Université Paris-Saclay, UVSQ, Inserm, Équipe "Exposome et Hérédité", CESP, Villejuif, France
| | - Monia Marchetti
- Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Barbora Weinbergerová
- Department of Internal Medicine - Hematology and Oncology, Masaryk University Hospital Brno, Brno, Czech Republic
| | - Ozren Jaksic
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia
| | - Moraima Jiménez
- Department of Hematology, Vacute lymphoid leukaemia d'Hebron Hospital Universitari, Experimental Hematology, Vacute lymphoid leukaemia d'Hebron Institute of Oncology (VHIO), Vacute lymphoid leukaemia d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Yavuz M Bilgin
- Department of Internal Medicine, ADRZ, Goes, Netherlands
| | | | | | - Pavel Žák
- University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Luisa Verga
- Azienda Ospedaliera San Gerardo - Monza, Monza, Italy; Università Milano-Bicocca, Milan, Italy
| | - Graham P Collins
- NIHR Oxford Biomedical Research Centre, Churchill Hospital, Oxford, United Kingdom
| | - Valentina Bonuomo
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy; Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Jens Van Praet
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - Marcio Nucci
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Ildefonso Espigado
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS / CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | | | - Toni Valković
- University Hospital Centre Rijeka, Rijeka, Croatia; Croatian Cooperative Group for Hematological Diseases (CROHEM), Faculty of Medicine and Faculty of Health Studies University of Rijeka, Rijeka, Croatia
| | | | - Natasha Čolović
- University Clinical Center Serbia, Medical Faculty University Belgrade, Belgrade, Serbia
| | - Giulia Dragonetti
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | | | - Carlo Tascini
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | | | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Marina Machado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Jorge Labrador
- Department of Hematology, Research Unit, Hospital Universitario de Burgos, Burgos, Spain
| | | | - Martin Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lucia Prezioso
- Hospital University of Parma - Hematology and Bone Marrow Unit, Parma, Italy
| | - Iker Falces-Romero
- La Paz University Hospital, Madrid, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Austin Kulasekararaj
- King's College Hospital, London, United Kingdom; King's College London, London, United Kingdom
| | | | - Noemí Fernández
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Ghaith Abu-Zeinah
- Division of Hematology and Oncology, Weill Cornell Medicine, New York, United States
| | | | | | - Klára Piukovics
- Department of Internal Medicine, South Division Faculty of Medicine University of Szeged, Szeged, Hungary
| | - Igor Stoma
- Gomel State Medical University, Gomel, Belarus
| | - Annarosa Cuccaro
- Hematology Unit, Center for Translational Medicine, Azienda USL Toscana NordOvest, Livorno, Italy
| | | | | | | | | | - Rui Bergantim
- Centro Hospitalar e Universitário São João, Porto, Portugal
| | - Uluhan Sili
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Johan Maertens
- Department of Microbiology, Immunology, and Transplantation, KULeuven, Leuven and Department of Hematology, UZ Leuven, Leuven, Belgium
| | - Fatih Demirkan
- Dokuz Eylul University, Division of Hematology, Izmir, Turkey
| | - Cristina De Ramón
- Hematology Department, Hospital Universitario de Salamanca, Salamanca, Spain; IBSAL, Centro de Investigación del Cáncer-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Verena Petzer
- Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Milan Navrátil
- Head of the ICU and Transplant Unit, Department of Hematooncology, University Hospital of Ostrava, Ostrava-Poruba, Czech Republic
| | | | | | | | - Zdeněk Ráčil
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - László Imre Pinczés
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Tobias Lahmer
- Medizinische Klinik II, Klinikum rechts der Isar, TU München, Munich, Germany
| | - Alessandro Busca
- Stem Cell Transplant Center, AOU Citta' della Salute e della Scienza, Turin, Italy
| | | | - Antonio Vena
- IRCCS AOU San Martino (IRCCS Ospedale Policlinico San Martino), Genova, Italia
| | - Monika M Biernat
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Maria Merelli
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | | | - Aleksandra Barać
- Clinic of Hematology, Clinical Center of Serbia, Belgrade, Serbia
| | - Martina Bavastro
- IRCCS AOU San Martino (IRCCS Ospedale Policlinico San Martino), Genova, Italia
| | | | | | - Dominik Wolf
- Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Gökçe Melis Çolak
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Ramón García-Sanz
- IBSAL, Centro de Investigación del Cáncer-IBMCC (USAL-CSIC), Salamanca, Spain; Head of Molecular Biology an HLA Unit, Department of Hematology, University Hospital of Salamanca (HUS/IBSAL/CIBERONC), Salamanca, Spain
| | - Ziad Emarah
- Oncology Center, Mansoura University, Mansoura, Egypt
| | - Bojana Mišković
- Hospital Clinic, Barcelona, Spain; Clinic for Orthopedic Surgery and Traumatology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Stefanie K Gräfe
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | - Anna Nordlander
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Elena Arellano
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS / CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | | | | | - Alba Cabirta
- Department of Hematology, Vacute lymphoid leukaemia d'Hebron Hospital Universitari, Experimental Hematology, Vacute lymphoid leukaemia d'Hebron Institute of Oncology (VHIO), Vacute lymphoid leukaemia d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Maria Vittoria Sacchi
- Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | - Ditte Stampe Hersby
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Michaela Hanakova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Laman Rahimli
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Raul Cordoba
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Oliver A Cornely
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany; University of Cologne, Faculty of Medicine, and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany; University of Cologne, Faculty of Medicine, and University Hospital Cologne, Center for Molecular Medicine Cologne (CMMC), Cologne, Germany
| | - Livio Pagano
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy; Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
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18
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Assanto GM, Totaro M, Poggiali R, Delli Paoli A, Annechini G, D'Elia GM, Aji F, Petrucci L, Fazio F, Del Giudice I, Martelli M, Micozzi A, Gentile G. Impact of Sars-CoV-2 Prophylaxis with Tixagevimab-Cilgavimab in High-Risk Patients with B-Cell Malignancies: A Single-Center Retrospective Study. Mediterr J Hematol Infect Dis 2023; 15:e2023061. [PMID: 38028390 PMCID: PMC10631717 DOI: 10.4084/mjhid.2023.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Severe Acute Respiratory Syndrome CoronaVirus‐2 (SARS‐CoV‐2) infection can result in different clinical manifestations (COVID-19), starting from asymptomatic disease to life threatening respiratory insufficiency. Onco-haematologic patients are at higher risk to develop severe COVID-19. In particular, patients affected by lymphoproliferative diseases, given the impaired cell-mediated and antibody-mediated immunity and treatment toxicity, develop more often a symptomatic and a more serious disease of Covid-19. Various therapeutic and prophylactic agents are being used against COVID‐19 such as antiviral drugs, vaccines and antiviral S‐protein monoclonal antibodies. Pre-exposure prophylaxis with AZD442/Evusheld (tixagevimab-cilgavimab) may be a complementary strategy to decrease the incidence or severity of COVID-19 for patients with B-cell malignancies. Tixagevimab-cilgavimab is a combination of two monoclonal antibodies that bind SARS-CoV-2 spike protein and inhibits the attachment to the surface of cells, preventing viral entry in the cell and COVID-19 development. In the setting of hematology real-life, few data are available on the impact of pre-exposure prophylaxis, given the multiple factors involved in the clinical behavior of SARS-CoV-2 . Our aim was to evaluate the clinical benefit and the safety of this strategy at our center.
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Affiliation(s)
| | - Matteo Totaro
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Rebecca Poggiali
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Adele Delli Paoli
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Giorgia Annechini
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Gianna Maria D'Elia
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Francesco Aji
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Luigi Petrucci
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Francesca Fazio
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Ilaria Del Giudice
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Maurizio Martelli
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Alessandra Micozzi
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Giuseppe Gentile
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
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19
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Guo W, Zheng Y, Feng S. Omicron related COVID-19 prevention and treatment measures for patients with hematological malignancy and strategies for modifying hematologic treatment regimes. Front Cell Infect Microbiol 2023; 13:1207225. [PMID: 37928188 PMCID: PMC10622671 DOI: 10.3389/fcimb.2023.1207225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/20/2023] [Indexed: 11/07/2023] Open
Abstract
The Omicron variant of SARS-CoV-2 has rapidly become the dominant strain worldwide due to its high transmissibility, although it appears to be less pathogenic than previous strains. However, individuals with hematological malignancy (HM) and COVID-19 remain susceptible to severe infection and mortality, especially those with chronic lymphocytic leukemia (CLL) and those undergoing chimeric antigen receptor T-cell (CAR-T) treatment. Hematologists should thoroughly assess the severity of the patient's hematological disease and the potential risk of SARS-CoV-2 infection before initiating chemotherapy or immunosuppressive treatment. Vaccination and booster doses are strongly recommended and patients with a poor vaccine response may benefit from long-acting COVID-19 neutralizing monoclonal antibodies (such as Evusheld). Early use of small molecule antiviral drugs is recommended for managing mild COVID-19 in HM patients and those with severe immunodeficiency may benefit from SARS-CoV-2 neutralizing monoclonal antibody therapy and high-titer COVID-19 convalescent plasma (CCP). For moderate to severe cases, low-dose glucocorticoids in combination with early antiviral treatment can be administered, with cytokine receptor antagonists or JAK inhibitors added if the condition persists or worsens. In the treatment of hematological malignancies, delaying chemotherapy is preferable for CLL, acute leukemia (AL), and low-risk myelodysplastic syndrome (MDS), but if the disease progresses, appropriate adjustments in dosage and frequency of treatment are required, with the avoidance of anti-CD20 monoclonal antibody, CAR-T and hematopoietic stem cell transplantation (HSCT). Patients with chronic myelocytic leukemia (CML) and myeloproliferative neoplasms (MPNs) can continue current treatment. What's more, non-drug protective measures, the development of new vaccines and antiviral drugs, and monitoring of mutations in immunocompromised populations are particularly important.
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Affiliation(s)
- Wenjing Guo
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Yizhou Zheng
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
| | - Sizhou Feng
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Tianjin Institutes of Health Science, Tianjin, China
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20
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Avdeev SN, Chulanov VP, Alexeeva EI, Aleshina OA, Bereznikov AV, Kotenko ON, Lila AM, Mutovina ZY, Parovichnikova EN, Fomina DS, Frolova NF, Shevchenko AO. [The burden of COVID-19 in a heterogeneous population of immunocompromised patients - realities of the postpandemic]. TERAPEVT ARKH 2023; 95:722-729. [PMID: 38158913 DOI: 10.26442/00403660.2023.08.202391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 10/11/2023] [Indexed: 01/03/2024]
Abstract
On July 3, 2023, an interdisciplinary Council of Experts "The burden of COVID-19 in a heterogeneous population of immunocompromised patients - post-pandemic realities" was held in Moscow with leading experts in pulmonology, rheumatology, hematology, oncology, nephrology, allergology-immunology, transplantation, and infectious diseases. The aim of the meeting was to discuss the current clinical and epidemiologic situation related to COVID-19, the relevance of disease prevention strategies for high-risk patients. The experts addressed the following issues: 1) the disease burden of COVID-19 in 2023 for patients with immunodeficiency in different therapeutic areas; 2) the place of passive immunization with monoclonal antibodies as a method of COVID-19 prophylaxis among immunocompromised patients; 3) prerequisites for the inclusion of passive immunization of immunocompromised patients into routine clinical practice.
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Affiliation(s)
- S N Avdeev
- Sechenov First Moscow State Medical University (Sechenov University)
| | - V P Chulanov
- Sechenov First Moscow State Medical University (Sechenov University)
- National Medical Research Center for Phthisiopulmonology and Infectious Diseases
| | - E I Alexeeva
- Sechenov First Moscow State Medical University (Sechenov University)
- National Medical Research Center for Children's Health
| | | | | | - O N Kotenko
- City Clinical Hospital №52
- Pirogov Russian National Research Medical University
| | - A M Lila
- Nasonova Research Institute of Rheumatology
- Russian Medical Academy of Continuous Professional Education
| | - Z Y Mutovina
- City Clinical Hospital №52
- Central State Medical Academy of the Administrative Department of the President of the Russian Federation
| | | | - D S Fomina
- Sechenov First Moscow State Medical University (Sechenov University)
- City Clinical Hospital №52
| | - N F Frolova
- City Clinical Hospital №52
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - A O Shevchenko
- Sechenov First Moscow State Medical University (Sechenov University)
- Pirogov Russian National Research Medical University
- Shumakov National Medical Research Center for Transplantology and Artificial Organs
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21
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Salmanton-García J, Marchesi F, Koehler P, Weinbergerová B, Čolović N, Falces-Romero I, Buquicchio C, Farina F, van Praet J, Biernat MM, Itri F, Prezioso L, Tascini C, Vena A, Romano A, Delia M, Dávila-Valls J, Martín-Pérez S, Lavilla-Rubira E, Adžić-Vukičević T, García-Bordallo D, López-García A, Criscuolo M, Petzer V, Fracchiolla NS, Espigado I, Sili U, Meers S, Erben N, Cattaneo C, Tragiannidis A, Gavriilaki E, Schönlein M, Mitrovic M, Pantic N, Merelli M, Labrador J, Hernández-Rivas JÁ, Glenthøj A, Fouquet G, Del Principe MI, Dargenio M, Calbacho M, Besson C, Kohn M, Gräfe S, Hersby DS, Arellano E, Çolak GM, Wolf D, Marchetti M, Nordlander A, Blennow O, Cordoba R, Mišković B, Mladenović M, Bavastro M, Limongelli A, Rahimli L, Pagano L, Cornely OA. Molnupiravir compared to nirmatrelvir/ritonavir for COVID-19 in high-risk patients with haematological malignancy in Europe. A matched-paired analysis from the EPICOVIDEHA registry. Int J Antimicrob Agents 2023; 62:106952. [PMID: 37582478 DOI: 10.1016/j.ijantimicag.2023.106952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/24/2023] [Accepted: 08/05/2023] [Indexed: 08/17/2023]
Abstract
INTRODUCTION Molnupiravir and nirmatrelvir/ritonavir are antivirals used to prevent progression to severe SARS-CoV-2 infections and decrease hospitalisation and mortality rates. Nirmatrelvir/ritonavir was authorised in Europe in December 2021, whereas molnupiravir is not yet licensed in Europe as of February 2022. Molnupiravir may be an alternative to nirmatrelvir/ritonavir because it is associated with fewer drug-drug interactions and contraindications. A caveat for molnupiravir is the mode of action induces viral mutations. Mortality rate reduction with molnupiravir was less pronounced than that with nirmatrelvir/ritonavir in patients without haematological malignancy. Little is known about the comparative efficacy of the two drugs in patients with haematological malignancy at high-risk of severe COVID-19. Thus, molnupiravir and nirmatrelvir/ritonavir were compared in a cohort of patients with haematological malignancies. METHODS Clinical data from patients treated with molnupiravir or nirmatrelvir/ritonavir monotherapy for COVID-19 were retrieved from the EPICOVIDEHA registry. Patients treated with molnupiravir were matched by sex, age (±10 years), and severity of baseline haematological malignancy to controls treated with nirmatrelvir/ritonavir. RESULTS A total of 116 patients receiving molnupiravir for the clinical management of COVID-19 were matched to an equal number of controls receiving nirmatrelvir/ritonavir. In each of the groups, 68 (59%) patients were male; with a median age of 64 years (interquartile range [IQR] 53-74) for molnupiravir recipients and 64 years (IQR 54-73) for nirmatrelvir/ritonavir recipients; 56.9% (n=66) of the patients had controlled baseline haematological malignancy, 12.9% (n=15) had stable disease, and 30.2% (n=35) had active disease at COVID-19 onset in each group. During COVID-19 infection, one third of patients from each group were admitted to hospital. Although a similar proportion of patients in the two groups were vaccinated (molnupiravir n=77, 66% vs. nirmatrelvir/ritonavir n=87, 75%), more of those treated with nirmatrelvir/ritonavir had received four vaccine doses (n=27, 23%) compared with those treated with molnupiravir (n=5, 4%) (P<0.001). No differences were detected in COVID-19 severity (P=0.39) or hospitalisation (P=1.0). No statistically significant differences were identified in overall mortality rate (P=0.78) or survival probability (d30 P=0.19, d60 P=0.67, d90 P=0.68, last day of follow up P=0.68). Deaths were either attributed to COVID-19, or the infection was judged by the treating physician to have contributed to death. CONCLUSIONS Hospitalisation and mortality rates with molnupiravir were comparable to those with nirmatrelvir/ritonavir in high-risk patients with haematological malignancies and COVID-19. Molnupiravir is a plausible alternative to nirmatrelvir/ritonavir for COVID-19 treatment in patients with haematological malignancy.
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Affiliation(s)
- Jon Salmanton-García
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Philipp Koehler
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Barbora Weinbergerová
- Department of Internal Medicine - Hematology and Oncology, Masaryk University Hospital Brno, Brno, Czech Republic
| | - Natasa Čolović
- University Clinical Center Serbia, Medical Faculty University Belgrade, Belgrade, Serbia
| | - Iker Falces-Romero
- La Paz University Hospital, Madrid, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Jens van Praet
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - Monika M Biernat
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Federico Itri
- San Luigi Gonzaga Hospital - Orbassano, Orbassano, Italy
| | - Lucia Prezioso
- Hospital University of Parma - Hematology and Bone Marrow Unit, Parma, Italy
| | - Carlo Tascini
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | | | | | - Mario Delia
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy
| | | | | | | | | | | | - Alberto López-García
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Mariana Criscuolo
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | - Verena Petzer
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck (MUI), Innsbruck, Austria
| | | | - Ildefonso Espigado
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS / CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | - Uluhan Sili
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | | | - Nurettin Erben
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine Eskisehir Osmangazi University, Eskisehir, Turkey
| | | | | | | | - Martin Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mirjana Mitrovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic of Hematology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Nikola Pantic
- Clinic of Hematology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Maria Merelli
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | - Jorge Labrador
- Department of Hematology, Research Unit, Hospital Universitario de Burgos, Burgos, Spain; Facultad de Ciencias de la Salud, Universidad Isabel I, Burgos, Spain
| | - José-Ángel Hernández-Rivas
- Hospital Universitario Infanta Leonor, Madrid, Spain; Departmento de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | | | | | | | | | - Caroline Besson
- Centre Hospitalier de Versailles, Le Chesnay, France; Université Paris-Saclay, UVSQ, Inserm, Équipe "Exposome et Hérédité", CESP, Villejuif, France
| | - Milena Kohn
- Centre Hospitalier de Versailles, Le Chesnay, France; Université Paris-Saclay, UVSQ, Inserm, Équipe "Exposome et Hérédité", CESP, Villejuif, France
| | - Stefanie Gräfe
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ditte Stampe Hersby
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Elena Arellano
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS / CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | - Gökçe Melis Çolak
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Dominik Wolf
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck (MUI), Innsbruck, Austria
| | - Monia Marchetti
- Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Anna Nordlander
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Raul Cordoba
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Bojana Mišković
- Center of Radiology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Miloš Mladenović
- University Clinic for Orthopedic Surgery and Traumatology, University Clinical Center of Serbia, Belgrade, Serbia
| | | | - Alessandro Limongelli
- University Clinical Center Serbia, Medical Faculty University Belgrade, Belgrade, Serbia
| | - Laman Rahimli
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Livio Pagano
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy; Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Oliver A Cornely
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany; University of Cologne, Faculty of Medicine, and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany; University of Cologne, Faculty of Medicine, and University Hospital Cologne, Center for Molecular Medicine Cologne (CMMC), Cologne, Germany.
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22
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Miao J, Zhang JY, Liang J, Zhao FY, Song H, Xu WQ, Tang YM, Xu XJ, Shu Q. Efficacy of inactivated SARS-CoV-2 vaccination in pediatric hematology/oncology patients: a real-world study. World J Pediatr 2023; 19:1017-1021. [PMID: 37525069 PMCID: PMC10497423 DOI: 10.1007/s12519-023-00737-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/31/2023] [Indexed: 08/02/2023]
Affiliation(s)
- Jing Miao
- Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
- National Clinical Research Center for Child Health, Hangzhou, China
| | - Jing-Ying Zhang
- Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
- National Clinical Research Center for Child Health, Hangzhou, China
| | - Juan Liang
- Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
- National Clinical Research Center for Child Health, Hangzhou, China
| | - Fen-Ying Zhao
- Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
- National Clinical Research Center for Child Health, Hangzhou, China
| | - Hua Song
- Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
- National Clinical Research Center for Child Health, Hangzhou, China
| | - Wei-Qun Xu
- Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
- National Clinical Research Center for Child Health, Hangzhou, China
| | - Yong-Min Tang
- Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
- National Clinical Research Center for Child Health, Hangzhou, China
| | - Xiao-Jun Xu
- Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China.
- National Clinical Research Center for Child Health, Hangzhou, China.
| | - Qiang Shu
- Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China.
- National Clinical Research Center for Child Health, Hangzhou, China.
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23
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Luttwak E, Noy A, Seshan V, Saltzman LA, Greenberger LM. The efficacy of tixagevimab-cilgavimab prophylaxis against Omicron BA.5 variants in patients with hematological malignancies: insights from the Leukemia and Lymphoma Society Registry. Leuk Lymphoma 2023; 64:1727-1729. [PMID: 37384591 PMCID: PMC11099848 DOI: 10.1080/10428194.2023.2227749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 07/01/2023]
Affiliation(s)
- Efrat Luttwak
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ariela Noy
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Venkatraman Seshan
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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24
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Cesaro S, Mikulska M, Hirsch HH, Styczynski J, Meylan S, Cordonnier C, Navarro D, von Lilienfeld-Toal M, Mehra V, Marchesi F, Besson C, Masculano RC, Beutel G, Einsele H, Maertens J, de la Camara R, Ljungman P, Pagano L. Update of recommendations for the management of COVID-19 in patients with haematological malignancies, haematopoietic cell transplantation and CAR T therapy, from the 2022 European Conference on Infections in Leukaemia (ECIL 9). Leukemia 2023; 37:1933-1938. [PMID: 37460673 PMCID: PMC10457191 DOI: 10.1038/s41375-023-01938-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/05/2023] [Accepted: 05/31/2023] [Indexed: 08/27/2023]
Affiliation(s)
- Simone Cesaro
- Paediatric Haematology-Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
| | - Malgorzata Mikulska
- Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Hans H Hirsch
- Transplantation & Clinical Virology, Department of Biomedicine, University of Basel, Basel, Switzerland
- Clinical Virology, Laboratory Medicine, University Hospital Basel, Basel, Switzerland
- Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Jan Styczynski
- Department of Paediatric Haematology and Oncology, Jurasz University Hospital, Nicolaus Copernicus University Torun, Collegium Medicum, Bydgoszcz, Poland
| | - Sylvain Meylan
- Infectious Diseases Service, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Catherine Cordonnier
- Haematology Department, Henri Mondor Hospital, APHP, and University Paris Est-Créteil, Paris, France
| | - Davide Navarro
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
- Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain
| | - Marie von Lilienfeld-Toal
- Klinik fur Innere Medizin II (Haematologie/Oncologie), Universitatsklinikum Jena, Jena, Germany
- Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany
| | - Varun Mehra
- Department of Haematology, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Francesco Marchesi
- Haematology Unit, Department of Research and Clinical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Caroline Besson
- Service d'Hematologie Oncologie, Centre Hospitalier de Versailles, Le Chesnay, Villejuif, France
| | - Raul Cordoba Masculano
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Gernot Beutel
- Department for Haematology, Haemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Herman Einsele
- Department of Internal Medicine II, University of Würzburg, Würzburg, Germany
| | - Johan Maertens
- Haematology Department, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | | | - Per Ljungman
- Division of Haematology, Department of Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden
- Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Livio Pagano
- Institute of Haematology, Faculty of Medicine and Surgery, "Sacro Cuore" Catholic University, Rome, Italy
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25
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Passamonti F, Bandera A. Early treatment for COVID-19 in patients with haematological malignancies: Much more than a recommendation! Br J Haematol 2023; 202:913-915. [PMID: 37438256 DOI: 10.1111/bjh.18977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 06/28/2023] [Accepted: 07/04/2023] [Indexed: 07/14/2023]
Affiliation(s)
- Francesco Passamonti
- Università degli Studi di Milano, Milan, Italy
- Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandra Bandera
- Università degli Studi di Milano, Milan, Italy
- Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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26
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Huang CT, Lee CP, Chen TY, Liu YC, Cho SF, Du JS, Yu ML, Huang CF, Wang SF, Hsiao HH. Serological Responses and Predictive Factors of Booster COVID-19 Vaccines in Patients with Hematologic Malignancies. J Clin Med 2023; 12:5647. [PMID: 37685720 PMCID: PMC10488979 DOI: 10.3390/jcm12175647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/01/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
Patients with hematologic malignancies are reported to have a more severe course of coronavirus disease 2019 (COVID-19) and be less responsive to vaccination. In this prospective study, we aimed to evaluate the serological responses to booster COVID-19 vaccines of Taiwanese patients with hematologic malignancies and identify potential predictive markers for effective neutralizing immunity. This study enrolled 68 patients with hematologic malignancies and 68 age- and gender-matched healthy control subjects who received three doses of vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from 1 January 2022 to 31 October 2022. The SARS-CoV-2 immunoglobulin G (IgG) spike antibody level was measured with the Abbott assay. The effective neutralization capacity was defined as an anti-spike IgG level of ≥4160 AU/mL. Among the 68 patients with hematologic malignancies, 89.7% achieved seroconversion after booster doses. Seven patients with actively treated lymphoma remained seronegative and had the lowest humoral responses among patients with different types of hematologic malignancies. Despite comparable antibody titers between patients and healthy individuals, rates of effective neutralization (66.2% vs. 86.8%, respectively; p = 0.005) were significantly reduced in patients with hematologic malignancies. In a multivariate analysis, the independent predictors for effective neutralization were a lack of B-cell-targeted agents within six months of vaccination (odds ratio, 15.2; 95% confidence interval, 2.7-84.2; p = 0.002) and higher immunoglobulin levels (odds ratio, 4.4; 95% confidence interval, 1.3-14.7; p = 0.017). In conclusion, the majority of patients with hematologic malignancies achieved seroconversion after booster vaccination. Patients with ongoing B-cell depletion and hypogammaglobinemia were identified as having negative predictive markers for effective neutralization.
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Affiliation(s)
- Chien-Tzu Huang
- Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-T.H.); (C.-P.L.); (Y.-C.L.); (S.-F.C.); (J.-S.D.)
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Ching-Ping Lee
- Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-T.H.); (C.-P.L.); (Y.-C.L.); (S.-F.C.); (J.-S.D.)
| | - Tzu-Yin Chen
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Yi-Chang Liu
- Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-T.H.); (C.-P.L.); (Y.-C.L.); (S.-F.C.); (J.-S.D.)
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Shih-Feng Cho
- Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-T.H.); (C.-P.L.); (Y.-C.L.); (S.-F.C.); (J.-S.D.)
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Jeng-Shiun Du
- Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-T.H.); (C.-P.L.); (Y.-C.L.); (S.-F.C.); (J.-S.D.)
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Ming-Lung Yu
- Division of Hepatobiliary, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (M.-L.Y.); (C.-F.H.)
- School of Medicine and Doctoral Program of Clinical and Experimental Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-sen University, Kaohsiung 804, Taiwan
| | - Chung-Feng Huang
- Division of Hepatobiliary, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (M.-L.Y.); (C.-F.H.)
- Ph.D. Program in Translational Medicine, College of Medicine, Kaohsiung Medical University and Academia Sinica, Kaohsiung 807, Taiwan
| | - Sheng-Fan Wang
- Center for Tropical Medicine and Infectious Disease Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Hui-Hua Hsiao
- Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-T.H.); (C.-P.L.); (Y.-C.L.); (S.-F.C.); (J.-S.D.)
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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27
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Andersson M, Wu J, Wullimann D, Gao Y, Aberg M, Muschiol S, Healy K, Naud S, Bogdanovic G, Palma M, Mellstedt H, Chen P, Ljunggren HG, Hansson L, Sallberg Chen M, Buggert M, Ingelman-Sundberg HM, Osterborg A. Local and Systemic Immunity During Five Vaccinations Against SARS-CoV-2 in Zanubrutinib-Treated Patients With Chronic Lymphocytic Leukemia. J Hematol 2023; 12:170-175. [PMID: 37692865 PMCID: PMC10482612 DOI: 10.14740/jh1140] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 07/14/2023] [Indexed: 09/12/2023] Open
Abstract
Background Patients with chronic lymphocytic leukemia (CLL) are vulnerable to coronavirus disease 2019 (COVID-19) and are at risk of inferior response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination, especially if treated with the first-generation Bruton's tyrosine kinase inhibitor (BTKi) ibrutinib. We aimed to evaluate the impact of the third-generation BTKi, zanubrutinib, on systemic and mucosal response to SARS-CoV-2 vaccination. Methods Nine patients with CLL with ongoing zanubrutinib therapy were included and donated blood and saliva during SARS-CoV-2 vaccination, before vaccine doses 3 and 5 and 2 - 3 weeks after doses 3, 4, and 5. Ibrutinib-treated control patients (n = 7) and healthy aged-matched controls (n = 7) gave blood 2 - 3 weeks after vaccine dose 5. We quantified reactivity and neutralization capacity of SARS-CoV-2-specific IgG and IgA antibodies (Abs) in both serum and saliva, and reactivity of T cells activated with viral peptides. Results Both zanubrutinib- and ibrutinib-treated patients had significantly, up to 1,000-fold, lower total spike-specific Ab levels after dose 5 compared to healthy controls (P < 0.01). Spike-IgG levels in serum from zanubrutinib-treated patients correlated well to neutralization capacity (r = 0.68; P < 0.0001) and were thus functional. Mucosal immunity (specific IgA in serum and saliva) was practically absent in zanubrutinib-treated patients even after five vaccine doses, whereas healthy controls had significantly higher levels (tested in serum after vaccine dose 5) (P < 0.05). In contrast, T-cell reactivity against SARS-CoV-2 peptides was equally high in zanubrutinib- and ibrutinib-treated patients as in healthy control donors. Conclusions In our small cohort of zanubrutinib-treated CLL patients, we conclude that up to five doses of SARS-CoV-2 vaccination induced no detectable IgA mucosal immunity, which likely will impair the primary barrier defence against the infection. Systemic IgG responses were also impaired, whereas T-cell responses were normal. Further and larger studies are needed to evaluate the impact of these findings on disease protection.
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Affiliation(s)
- Maria Andersson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Hematology, Karolinska University Hospital Solna, Stockholm, Sweden
- These authors contributed equally to this article
| | - Jinghua Wu
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
- These authors contributed equally to this article
| | - David Wullimann
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Yu Gao
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Aberg
- Department of Medical Sciences, Clinical Chemistry and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Sandra Muschiol
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Katie Healy
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Sabrina Naud
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Gordana Bogdanovic
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Marzia Palma
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Hematology, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Hakan Mellstedt
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Puran Chen
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Hans-Gustaf Ljunggren
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Lotta Hansson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Hematology, Karolinska University Hospital Solna, Stockholm, Sweden
| | | | - Marcus Buggert
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Hanna M. Ingelman-Sundberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Karolinska University Hospital Solna, Stockholm, Sweden
- These authors contributed equally to this article
| | - Anders Osterborg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Hematology, Karolinska University Hospital Solna, Stockholm, Sweden
- These authors contributed equally to this article
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28
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Szabó E, Modok S, Rónaszéki B, Faragó A, Gémes N, Nagy LI, Hackler L, Farkas K, Neuperger P, Balog JÁ, Balog A, Puskás LG, Szebeni GJ. Comparison of humoral and cellular immune responses in hematologic diseases following completed vaccination protocol with BBIBP-CorV, or AZD1222, or BNT162b2 vaccines against SARS-CoV-2. Front Med (Lausanne) 2023; 10:1176168. [PMID: 37529238 PMCID: PMC10389666 DOI: 10.3389/fmed.2023.1176168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/23/2023] [Indexed: 08/03/2023] Open
Abstract
Background Vaccination has proven the potential to control the COVID-19 pandemic worldwide. Although recent evidence suggests a poor humoral response against SARS-CoV-2 in vaccinated hematological disease (HD) patients, data on vaccination in these patients is limited with the comparison of mRNA-based, vector-based or inactivated virus-based vaccines. Methods Forty-nine HD patients and 46 healthy controls (HCs) were enrolled who received two-doses complete vaccination with BNT162b2, or AZD1222, or BBIBP-CorV, respectively. The antibodies reactive to the receptor binding domain of spike protein of SARS-CoV-2 were assayed by Siemens ADVIA Centaur assay. The reactive cellular immunity was assayed by flow cytometry. The PBMCs were reactivated with SARS-CoV-2 antigens and the production of activation-induced markers (TNF-α, IFN-γ, CD40L) was measured in CD4+ or CD8+ T-cells ex vivo. Results The anti-RBD IgG level was the highest upon BNT162b2 vaccination in HDs (1264 BAU/mL) vs. HCs (1325 BAU/mL) among the studied groups. The BBIBP-CorV vaccination in HDs (339.8 BAU/mL ***p < 0.001) and AZD1222 in HDs (669.9 BAU/mL *p < 0.05) resulted in weaker antibody response vs. BNT162b2 in HCs. The response rate of IgG production of HC vs. HD patients above the diagnostic cut-off value was 100% vs. 72% for the mRNA-based BNT162b2 vaccine; 93% vs. 56% for the vector-based AZD1222, or 69% vs. 33% for the inactivated vaccine BBIBP-CorV, respectively. Cases that underwent the anti-CD20 therapy resulted in significantly weaker (**p < 0.01) anti-RBD IgG level (302 BAU/mL) than without CD20 blocking in the HD group (928 BAU/mL). The response rates of CD4+ TNF-α+, CD4+ IFN-γ+, or CD4+ CD40L+ cases were lower in HDs vs. HCs in all vaccine groups. However, the BBIBP-CorV vaccine resulted the highest CD4+ TNF-α and CD4+ IFN-γ+ T-cell mediated immunity in the HD group. Conclusion We have demonstrated a significant weaker overall response to vaccines in the immunologically impaired HD population vs. HCs regardless of vaccine type. Although, the humoral immune activity against SARS-CoV-2 can be highly evoked by mRNA-based BNT162b2 vaccination compared to vector-based AZD1222 vaccine, or inactivated virus vaccine BBIBP-CorV, whereas the CD4+ T-cell mediated cellular activity was highest in HDs vaccinated with BBIBP-CorV.
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Affiliation(s)
- Enikő Szabó
- Laboratory of Functional Genomics, Biological Research Centre, Szeged, Hungary
| | - Szabolcs Modok
- Department of Medicine, Szent-Györgyi Albert Medical School-University of Szeged, Szeged, Hungary
| | - Benedek Rónaszéki
- Department of Medicine, Szent-Györgyi Albert Medical School-University of Szeged, Szeged, Hungary
| | - Anna Faragó
- Avidin Ltd., Szeged, Hungary
- Doctoral School in Biology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Nikolett Gémes
- Laboratory of Functional Genomics, Biological Research Centre, Szeged, Hungary
- Doctoral School in Biology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | | | | | | | - Patrícia Neuperger
- Laboratory of Functional Genomics, Biological Research Centre, Szeged, Hungary
- Doctoral School in Biology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - József Á. Balog
- Laboratory of Functional Genomics, Biological Research Centre, Szeged, Hungary
| | - Attila Balog
- Department of Rheumatology and Immunology, Faculty of Medicine, Albert Szent-Gyorgyi Health Centre, University of Szeged, Szeged, Hungary
| | - László G. Puskás
- Laboratory of Functional Genomics, Biological Research Centre, Szeged, Hungary
- Avidin Ltd., Szeged, Hungary
- Avicor Ltd., Szeged, Hungary
| | - Gabor J. Szebeni
- Laboratory of Functional Genomics, Biological Research Centre, Szeged, Hungary
- Department of Physiology, Anatomy and Neuroscience, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
- CS-Smartlab Devices, Kozarmisleny, Hungary
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29
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Xue E, Scorpio G, Ruggeri A, Clerici D, Farina F, Campodonico E, Acerbis A, Fiore P, Bruno A, Carrabba MG, Peccatori J, Greco R, Lupo Stanghellini MT, Ciceri F, Corti C. Impact of tixagevimab/cilgavimab prophylaxis in patients undergoing allogeneic hematopoietic stem cell transplants and CAR T-cell therapy: A single center experience. Curr Res Transl Med 2023; 71:103402. [PMID: 37399601 PMCID: PMC10299847 DOI: 10.1016/j.retram.2023.103402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/08/2023] [Accepted: 06/22/2023] [Indexed: 07/05/2023]
Affiliation(s)
- Elisabetta Xue
- Hematology and Bone Marrow Transplant Unit, San Raffaele Hospital, Milan, Italy.
| | - Gianluca Scorpio
- Hematology and Bone Marrow Transplant Unit, San Raffaele Hospital, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - Annalisa Ruggeri
- Hematology and Bone Marrow Transplant Unit, San Raffaele Hospital, Milan, Italy
| | - Daniela Clerici
- Hematology and Bone Marrow Transplant Unit, San Raffaele Hospital, Milan, Italy
| | - Francesca Farina
- Hematology and Bone Marrow Transplant Unit, San Raffaele Hospital, Milan, Italy
| | - Edoardo Campodonico
- Hematology and Bone Marrow Transplant Unit, San Raffaele Hospital, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Acerbis
- Hematology and Bone Marrow Transplant Unit, San Raffaele Hospital, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - Paolo Fiore
- Hematology and Bone Marrow Transplant Unit, San Raffaele Hospital, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - Alessandro Bruno
- Hematology and Bone Marrow Transplant Unit, San Raffaele Hospital, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - Matteo G Carrabba
- Hematology and Bone Marrow Transplant Unit, San Raffaele Hospital, Milan, Italy
| | - Jacopo Peccatori
- Hematology and Bone Marrow Transplant Unit, San Raffaele Hospital, Milan, Italy
| | - Raffaella Greco
- Hematology and Bone Marrow Transplant Unit, San Raffaele Hospital, Milan, Italy
| | | | - Fabio Ciceri
- Hematology and Bone Marrow Transplant Unit, San Raffaele Hospital, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - Consuelo Corti
- Hematology and Bone Marrow Transplant Unit, San Raffaele Hospital, Milan, Italy.
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30
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Defrancesco I, Ferretti VV, Morel P, Kyriakou C, Kastritis E, Tohidi-Esfahani I, Tedeschi A, Buske C, García-Sanz R, Vos JM, Peri V, Margiotta Casaluci G, Ferrari A, Piazza F, Oostvogels R, Lovato E, Montes L, Fornecker LM, Grunenberg A, Dimopoulos MA, Tam CS, D’Sa S, Leblond V, Trotman J, Passamonti F, Arcaini L, Varettoni M. SARS-CoV-2 Infection in Patients With Waldenström's Macroglobulinemia: A Multicenter International Cohort Study. Hemasphere 2023; 7:e887. [PMID: 37283569 PMCID: PMC10241499 DOI: 10.1097/hs9.0000000000000887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/04/2023] [Indexed: 06/08/2023] Open
Affiliation(s)
- Irene Defrancesco
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy
| | | | - Pierre Morel
- Service d’Hematologie Clinique et Therapie Cellulaire, Centre Hospitalier Universitaire d’Amiens-Picardie, France
| | - Charalampia Kyriakou
- Centre for Waldenström’s Macroglobulinaemia and Related Conditions, University College London Hospitals National Health Service Foundation Trust, London, United Kingdom
| | - Efstathios Kastritis
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | | | | | - Christian Buske
- Institute of Experimental Cancer Research, Comprehensive Cancer Center Ulm, University Hospital of Ulm, Germany
| | - Ramón García-Sanz
- Hematology Department, University Hospital of Salamanca, Research Biomedical Institute of Salamanca (IBSAL), CIBERONC and Center for Cancer Research-IBMCC (University of Salamanca-CSIC), Spain
| | - Josephine M.I. Vos
- Department of Hematology, Amsterdam UMC, Location University of Amsterdam, Cancer Center Amsterdam and LYMMCARE (Lymphoma and Myeloma Center Amsterdam), the Netherlands
| | - Veronica Peri
- Hematology Division, “AOU Città della Salute e della Scienza di Torino,” Italy
| | - Gloria Margiotta Casaluci
- Division of Hematology, Department of Translational Medicine, Hospital Maggiore della Carità, Novara, Italy
| | | | - Francesco Piazza
- Laboratory of Myeloma and Lymphoma Pathobiology, Veneto Institute of Molecular Medicine (VIMM) and Foundation for Advanced Biomedical Research (FABR), Padua, Italy
- Hematology Division, Azienda Ospedaliera Universitaria and Department of Medicine, University of Padua, Italy
| | | | - Ester Lovato
- Department of Medicine, Hematology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Lydia Montes
- Service d’Hematologie Clinique et Therapie Cellulaire, Centre Hospitalier Universitaire d’Amiens-Picardie, France
| | | | | | | | - Constantine S. Tam
- Peter MacCallum Cancer Centre and University of Melbourne, VIC, Australia
- Alfred Health and Monash University, Melbourne, VIC, Australia
- Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Shirley D’Sa
- Centre for Waldenström’s Macroglobulinaemia and Related Conditions, University College London Hospitals National Health Service Foundation Trust, London, United Kingdom
| | - Veronique Leblond
- Département d’Hématologie Hôpital Pitié-Salpêtrière APHP, UPMC Université Paris, France
| | - Judith Trotman
- Haematology Department, Concord Repatriation General Hospital, Sydney, NSW, Australia
- University of Sydney, Camperdown, NSW, Australia
| | - Francesco Passamonti
- Department of Hematology, University Hospital “Ospedale di Circolo e Fondazione Macchi - ASST SetteLaghi,” University of Insubria, Varese, Italy
| | - Luca Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, University of Pavia, Italy
| | - Marzia Varettoni
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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31
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Oltolini C, Acerbis A, Orofino G, Racca S, Noviello M, Dispinseri S, Clementi N, Piemontese S, Xue E, Giglio F, Lupo Stanghellini MT, Diral E, Bruno A, Tassi E, Beretta V, Marzinotto I, Scarlatti G, Lampasona V, Ardemagni A, Sampaolo M, Bonini C, Corti C, Peccatori J, Castagna A, Ciceri F, Greco R. Case Report: Favorable outcome of allogeneic hematopoietic stem cell transplantation in SARSCoV2 positive recipient, risk-benefit balance between infection and leukemia. Front Immunol 2023; 14:1184956. [PMID: 37287986 PMCID: PMC10242072 DOI: 10.3389/fimmu.2023.1184956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/09/2023] [Indexed: 06/09/2023] Open
Abstract
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) in SARS-CoV-2 positive candidates is usually delayed until the clinical resolution of the infection's symptoms and a negative nasopharyngeal molecular test. However, prolonged SARS-CoV-2 positivity has been frequently observed in haematological malignancies, thus representing a challenge for the timing of transplant procedures. Here, we report on the case of a 34-year-old patient with recent pauci-symptomatic COVID-19 undergoing transplant for high-risk acute B-lymphoblastic leukemia before achieving viral clearance. Shortly before their scheduled allogeneic HSCT from a matched unrelated donor, the patient developed mild Omicron BA.5 infection receiving nirmatrelvir/ritonavir with fever resolution within 72 hours. Twenty-three days after COVID-19 diagnosis, because of increasing minimal residual disease values in the context of high-risk refractory leukemia and clinical resolution of SARS-2-CoV infection with reduction of viral load at surveillance nasopharyngeal swabs, it was decided not to delay further allo-HSCT. During myelo-ablative conditioning, the nasopharyngeal SARS-CoV-2 viral load increased while the patient remained asymptomatic. Consequently, two days before the transplant, intra-muscular tixagevimab/cilgavimab 300/300 mg and a 3-day course of intravenous remdesivir were administered. During the pre-engraftment phase, veno-occlusive disease (VOD) occurred at day +13, requiring defibrotide treatment to obtain a slow but complete recovery. The post-engraftment phase was characterized by mild COVID-19 at day +23 (cough, rhino-conjunctivitis, fever) that spontaneously resolved, achieving viral clearance at day +28. At day +32, she experienced grade I acute graft-versus host disease (a-GVHD, skin grade II) treated with steroids and photo-apheresis, without further complications during follow-up until day +180. Addressing the issue of allo-HSCT timing in patients recovering from SARS-CoV-2 infection with high-risk malignant diseases is challenging because of 1] the high risk of COVID-19 clinical progression, 2] the impact of transplant delay on leukemia prognosis and 3] the occurrence of endothelial complications such as VOD, a-GVHD, and transplant associated thrombotic micro-angiopathy. Our report describes the favourable outcome of allo-HSCT in a recipient with active SARS-CoV2 infection and high-risk leukemia thanks to timely anti-SARS-CoV-2 preventive therapies and prompt management of transplant-related complications.
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Affiliation(s)
- Chiara Oltolini
- Clinic of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Acerbis
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Giorgio Orofino
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Sara Racca
- Laboratory of Microbiology and Virology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Maddalena Noviello
- Experimental Haematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Stefania Dispinseri
- Viral Evolution and Transmission Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Nicola Clementi
- University Vita-Salute San Raffaele, Milan, Italy
- Laboratory of Microbiology and Virology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Simona Piemontese
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Elisabetta Xue
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Fabio Giglio
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Maria Teresa Lupo Stanghellini
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Elisa Diral
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Alessandro Bruno
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Elena Tassi
- Experimental Haematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Valeria Beretta
- Experimental Haematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Ilaria Marzinotto
- Diabetes Research Institute Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Gabriella Scarlatti
- Viral Evolution and Transmission Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Vito Lampasona
- Diabetes Research Institute Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Anna Ardemagni
- Laboratory of Microbiology and Virology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Michela Sampaolo
- Laboratory of Microbiology and Virology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Bonini
- University Vita-Salute San Raffaele, Milan, Italy
- Experimental Haematology Unit, Division of Immunology, Transplantation and Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- Cell Therapy Immunomonitoring Laboratory (MITiCi), Division of Immunology, Transplantation and Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Consuelo Corti
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Jacopo Peccatori
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Clinic of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Fabio Ciceri
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Raffaella Greco
- Hematology and Bone Marrow Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
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32
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Aleshina OA, Zakurdaeva K, Vasileva AN, Dubov SK, Dubov VS, Vorobyev VI, Butaev LS, Sukhareva AM, Gavrilova LV, Toropova IY, Popova MO, Siniaev AA, Kulagin AD, Kaplanov KD, Petrenko AA, Ochirova OI, Karpova A, Chelysheva EY, Turkina AG, Gurianova MA, Al-Radi LS, Gilyazitdinova EA, Egorova EK, Chabaeva YA, Kulikov SM, Sveshnikova YV, Kunst MA, Shuvaev V, Rakhmani AF, Panteleeva OL, Grishunina ME, Samoylova OS, Vorontsova E, Baryshnikova DV, Parovichnikova EN. Clinical Outcomes in Patients With COVID-19 and Hematologic Disease. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2023:S2152-2650(23)00128-3. [PMID: 37236904 PMCID: PMC10102503 DOI: 10.1016/j.clml.2023.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/30/2023] [Accepted: 04/07/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND Patients with hematologic diseases are at higher risk of the SARS-CoV-2 infection and more severe clinical outcomes of the coronavirus disease. CHRONOS19 is an observational prospective cohort study with the aim to determine the short and longer-term clinical outcomes, risk factors for disease severity and mortality, and rates of postinfectious immunity in patients with malignant and nonmalignant hematologic diseases and COVID-19. PATIENTS AND METHODS Overall, 666 patients were enrolled in the study, of which 626 were included in the final data analysis. The primary endpoint was 30-days all-cause mortality. Secondary endpoints included COVID-19 complications, rates of ICU admission and mechanical ventilation, outcomes of a hematologic disease in SARS-CoV-2 infected patients, overall survival, and risk factors for disease severity and mortality. Data from 15 centers were collected at 30, 90, and 180 days after COVID-19 was diagnosed and were managed using a web-based e-data capture platform. All evaluations were performed in the pre-omicron period of COVID-19 pandemic. RESULTS Thirty-days all-cause mortality was 18.9%. The predominant cause of death (in 80% of cases) were COVID-19 complications. At 180 days, the majority (70%) of additional deaths were due to hematologic disease progression. At a median follow-up of 5.7 [0.03-19.04] months, 6-months overall survival was 72% [95% CI: 0.69-0.76]. One-third of patients had severe SARS-CoV-2 disease. The rate of ICU admission was 22% with 77% of these patients requiring mechanical ventilation, with poor survival rate. A univariate analysis revealed that older age (≥ 60 years), male sex, malignant hematologic disease, myelotoxic agranulocytosis, transfusion dependence, refractory disease or relapse, diabetes among comorbidities, any complications, especially ARDS alone or in combination with CRS, admission to an ICU, and mechanical ventilation were associated with higher risks of mortality. Treatment of the hematologic disease was changed, postponed, or canceled in 63% of patients. At a longer follow-up (90 and 180 days), the status of the hematologic disease changed in 7.5% of patients. CONCLUSION Patients with hematologic disease and COVID-19 have high mortality rates, predominantly due to COVID-19 complications. At a longer-term follow-up, no significant impact of COVID-19 on the course of a hematologic disease was revealed.
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Affiliation(s)
- Olga A Aleshina
- National Medical Research Center for Hematology, Moscow, Russia.
| | | | | | | | | | | | - Lev S Butaev
- S.P. Botkin City Clinical Hospital, Moscow, Russia
| | | | | | | | - Marina O Popova
- R.M. Gorbacheva Research Institute, Pavlov University, Saint-Petersburg, Russia
| | - Aleksandr A Siniaev
- R.M. Gorbacheva Research Institute, Pavlov University, Saint-Petersburg, Russia
| | - Aleksandr D Kulagin
- R.M. Gorbacheva Research Institute, Pavlov University, Saint-Petersburg, Russia
| | | | | | | | - Alina Karpova
- N.A. Semashko Republican Clinical Hospital, Ulan-Ude, Russia
| | | | - Anna G Turkina
- National Medical Research Center for Hematology, Moscow, Russia
| | | | | | | | - Elena K Egorova
- National Medical Research Center for Hematology, Moscow, Russia
| | | | | | | | | | - Vasily Shuvaev
- Research Institute of Hematology and Transfusiology, Saint-Petersburg, Russia
| | | | | | | | - Olga S Samoylova
- N.A. Semashko Regional Clinical Hospital, Nizhniy Novgorod, Russia
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Hus I, Szymczyk A, Mańko J, Drozd-Sokołowska J. COVID-19 in Adult Patients with Hematological Malignancies-Lessons Learned after Three Years of Pandemic. BIOLOGY 2023; 12:biology12040545. [PMID: 37106746 PMCID: PMC10136203 DOI: 10.3390/biology12040545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/22/2023] [Accepted: 03/27/2023] [Indexed: 04/29/2023]
Abstract
The COVID-19 pandemic is undoubtedly the most difficult health challenge of the 21st century with more than 600 million laboratory-confirmed SARS-CoV-2 infections and over 6.5 million deaths worldwide. The coronavirus pandemic contributed to rapid development of mRNA vaccines, which, along with new antiviral drugs, have been the subject of extensive research for many decades. Nevertheless, elderly, multi-morbid and immunocompromised patients continue to face a more severe clinical course and a higher risk of death from COVID-19, even now that the risk of COVID-19 in the general population is significantly reduced due to the introduction of global vaccination strategies. In this paper, we present the mechanisms of increased susceptibility to infectious complications and the evolution of the clinical course of COVID-19 in patients with hematological malignancies, taking into account the mutation of the virus and the introduction of vaccines and new antiviral drugs. We also present current recommendations for prophylactic and therapeutic management in patients with hematological malignancies.
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Affiliation(s)
- Iwona Hus
- Department of Hematology, National Medical Institute of the Ministry of Interior and Administration, 137 Wołoska Str., 02-507 Warsaw, Poland
- Department of Clinical Transplantology, Medical University of Lublin, 7 Chodźki Str., 20-093 Lublin, Poland
| | - Agnieszka Szymczyk
- Department of Hematology, National Medical Institute of the Ministry of Interior and Administration, 137 Wołoska Str., 02-507 Warsaw, Poland
- Department of Clinical Transplantology, Medical University of Lublin, 7 Chodźki Str., 20-093 Lublin, Poland
| | - Joanna Mańko
- Department of Hematology, National Medical Institute of the Ministry of Interior and Administration, 137 Wołoska Str., 02-507 Warsaw, Poland
| | - Joanna Drozd-Sokołowska
- Department of Hematology, Oncology and Internal Medicine, Medical University of Warsaw, 1a Banacha Str., 02-097 Warsaw, Poland
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Nirmatrelvir/ritonavir in COVID-19 patients with haematological malignancies: a report from the EPICOVIDEHA registry. EClinicalMedicine 2023; 58:101939. [PMID: 37041967 PMCID: PMC10078172 DOI: 10.1016/j.eclinm.2023.101939] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 04/08/2023] Open
Abstract
Background Nirmatrelvir/ritonavir treatment decreases the hospitalisation rate in immunocompetent patients with COVID-19, but data on efficacy in patients with haematological malignancy are scarce. Here, we describe the outcome of nirmatrelvir/ritonavir treatment in a large cohort of the latter patients. Methods This is a retrospective cohort study from the multicentre EPICOVIDEHA registry (NCT04733729) on patients with haematological malignancy, who were diagnosed with COVID-19 between January and September 2022. Patients receiving nirmatrelvir/ritonavir were compared to those who did not. A logistic regression was run to determine factors associated with nirmatrelvir/ritonavir administration in our sample. Mortality between treatment groups was assessed with Kaplan–Meier survival plots after matching all the patients with a propensity score. Additionally, a Cox regression was modelled to detect factors associated with mortality in patients receiving nirmatrelvir/ritonavir. Findings A total of 1859 patients were analysed, 117 (6%) were treated with nirmatrelvir/ritonavir, 1742 (94%) were treated otherwise. Of 117 patients receiving nirmatrelvir/ritonavir, 80% had received ≥1 anti-SARS-CoV-2 vaccine dose before COVID-19 onset, 13% of which received a 2nd vaccine booster. 5% were admitted to ICU. Nirmatrelvir/ritonavir treatment was associated with the presence of extrapulmonary symptoms at COVID-19 onset, for example anosmia, fever, rhinitis, or sinusitis (aOR 2.509, 95%CI 1.448–4.347) and 2nd vaccine booster (aOR 3.624, 95%CI 1.619–8.109). Chronic pulmonary disease (aOR 0.261, 95%CI 0.093–0.732) and obesity (aOR 0.105, 95%CI 0.014–0.776) were not associated with nirmatrelvir/ritonavir use. After propensity score matching, day-30 mortality rate in patients treated with nirmatrelvir/ritonavir was 2%, significantly lower than in patients with SARS-CoV-2 directed treatment other than nirmatrelvir/ritonavir (11%, p = 0.036). No factor was observed explaining the mortality difference in patients after nirmatrelvir/ritonavir administration. Interpretation Haematological malignancy patients were more likely to receive nirmatrelvir/ritonavir when reporting extrapulmonary symptoms or 2nd vaccine booster at COVID-19 onset, as opposed to chronic pulmonary disease and obesity. The mortality rate in patients treated with nirmatrelvir/ritonavir was lower than in patients with targeted drugs other than nirmatrelvir/ritonavir. Funding EPICOVIDEHA has received funds from Optics COMMIT (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223).
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Convalescent Plasma Treatment of Patients Previously Treated with B-Cell-Depleting Monoclonal Antibodies Suffering COVID-19 Is Associated with Reduced Re-Admission Rates. Viruses 2023; 15:v15030756. [PMID: 36992465 PMCID: PMC10059055 DOI: 10.3390/v15030756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/12/2023] [Accepted: 03/12/2023] [Indexed: 03/17/2023] Open
Abstract
Patients receiving treatment with B-cell-depleting monoclonal antibodies, such as anti-CD20 monoclonal antibodies, such as rituximab and obinutuzumab, either for hematological disease or another diagnosis, such as a rheumatological disease, are at an increased risk for medical complications and mortality from COVID-19. Since inconsistencies persist regarding the use of convalescent plasma (CP), especially in the vulnerable patient population that has received previous treatment with B-cell-depleting monoclonal antibodies, further studies should be performed in thisdirection. The aim of the present study was to describe the characteristics of patients with previous use of B-cell-depleting monoclonal antibodies and describe the potential beneficial effects of CP use in terms of mortality, ICU admission and disease relapse. In this retrospective cohort study, 39 patients with previous use of B-cell-depleting monoclonal antibodies hospitalized in the COVID-19 department of a tertiary hospital in Greece were recorded and evaluated. The mean age was 66.3 years and 51.3% were male. Regarding treatment for COVID-19, remdesivir was used in 89.7%, corticosteroids in 94.9% and CP in 53.8%. In-hospital mortality was 15.4%. Patients who died were more likely to need ICU admission and also had a trend towards a longer hospital stay, even though the last did not reach statistical significance. Patients treated with CP had a lower re-admission rate for COVID-19 after discharge. Further studies should be performed to identify the role of CP in patients with treatment with B-cell-depleting monoclonal antibodies suffering from COVID-19.
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Spiliopoulou V, Ntanasis-Stathopoulos I, Malandrakis P, Gavriatopoulou M, Theodorakakou F, Fotiou D, Migkou M, Roussou M, Eleutherakis-Papaiakovou E, Kastritis E, Dimopoulos MA, Terpos E. Use of Oral Antivirals Ritonavir-Nirmatrelvir and Molnupiravir in Patients with Multiple Myeloma Is Associated with Low Rates of Severe COVID-19: A Single-Center, Prospective Study. Viruses 2023; 15:v15030704. [PMID: 36992413 PMCID: PMC10054373 DOI: 10.3390/v15030704] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/23/2023] [Accepted: 03/07/2023] [Indexed: 03/31/2023] Open
Abstract
In patients with multiple myeloma (MM), SARS-CoV-2 infection has been associated with a severe clinical course and high mortality rates due to the concomitant disease- and treatment-related immunosuppression. Specific antiviral treatment involves viral replication control with monoclonal antibodies and antivirals, including molnupiravir and the ritonavir-boosted nirmatrelvir. This prospective study investigated the effect of these two agents on SARS-CoV-2 infection severity and mortality in patients with MM. Patients received either ritonavir-nirmatrelvir or molnupiravir. Baseline demographic and clinical characteristics, as well as levels of neutralizing antibodies (NAbs), were compared. A total of 139 patients was treated with ritonavir-nirmatrelvir while the remaining 30 patients were treated with molnupiravir. In total, 149 patients (88.2%) had a mild infection, 15 (8.9%) had a moderate infection, and five (3%) had severe COVID-19. No differences in the severity of COVID-19-related outcomes were observed between the two antivirals. Patients with severe disease had lower neutralizing antibody levels before the COVID-19 infection compared to patients with mild disease (p = 0.04). Regarding treatment, it was observed that patients receiving belantamab mafodotin had a higher risk of severe COVID-19 (p < 0.001) in the univariate analysis. In conclusion, ritonavir-nirmatrelvir and molnupiravirmay prevent severe disease in MM patients with SARS-CoV-2 infection. This prospective study indicated the comparable effects of the two treatment options, providing an insight for further research in preventing severe COVID-19 in patients with hematologic malignancies.
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Affiliation(s)
- Vassiliki Spiliopoulou
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Ioannis Ntanasis-Stathopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Panagiotis Malandrakis
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Maria Gavriatopoulou
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Foteini Theodorakakou
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Despina Fotiou
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Magdalini Migkou
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Maria Roussou
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | | | - Efstathios Kastritis
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Meletios A Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Evangelos Terpos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
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Hematological Questions in Personalized Management of COVID-19 Vaccination. J Pers Med 2023; 13:jpm13020259. [PMID: 36836493 PMCID: PMC9965747 DOI: 10.3390/jpm13020259] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/27/2023] [Accepted: 01/29/2023] [Indexed: 02/01/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been causing a worldwide pandemic since 2019. Many vaccines have been manufactured and have shown promising results in reducing disease morbidity and mortality. However, a variety of vaccine-related adverse effects, including hematological events, have been reported, such as thromboembolic events, thrombocytopenia, and bleeding. Moreover, a new syndrome, vaccine-induced immune thrombotic thrombocytopenia, following vaccination against COVID-19 has been recognized. These hematologic side effects have also raised concerns about SARS-CoV-2 vaccination in patients with preexisting hematologic conditions. Patients with hematological tumors are at a higher risk of severe SARS-CoV-2 infection, and the efficacy and safety of vaccination in this group remain uncertain and have raised attention. In this review, we discuss the hematological events following COVID-19 vaccination and vaccination in patients with hematological disorders.
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[Chinese consensus on severe acute respiratory syndrome coronavirus-2 vaccination in adult patients with hematological diseases (2023)]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2023; 44:19-25. [PMID: 36599437 PMCID: PMC10067370 DOI: 10.3760/cma.j.issn.0253-2727.2023.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Indexed: 01/06/2023]
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Ljungman P, Tridello G, Piñana JL, Ciceri F, Sengeloev H, Kulagin A, Mielke S, Yegin ZA, Collin M, Einardottir S, Lepretre SD, Maertens J, Campos A, Metafuni E, Pichler H, Folber F, Solano C, Nicholson E, Yüksel MK, Carlson K, Aguado B, Besley C, Byrne J, Heras I, Dignan F, Kröger N, Robin C, Khan A, Lenhoff S, Grassi A, Dobsinska V, Miranda N, Jimenez MJ, Yonal-Hindilerden I, Wilson K, Averbuch D, Cesaro S, Xhaard A, Knelange N, Styczynski J, Mikulska M, de la Camara R. Improved outcomes over time and higher mortality in CMV seropositive allogeneic stem cell transplantation patients with COVID-19; An infectious disease working party study from the European Society for Blood and Marrow Transplantation registry. Front Immunol 2023; 14:1125824. [PMID: 36960069 PMCID: PMC10028143 DOI: 10.3389/fimmu.2023.1125824] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/22/2023] [Indexed: 03/09/2023] Open
Abstract
Introduction COVID-19 has been associated with high morbidity and mortality in allogeneic hematopoietic stem cell transplant (allo-HCT) recipients. Methods This study reports on 986 patients reported to the EBMT registry during the first 29 months of the pandemic. Results The median age was 50.3 years (min - max; 1.0 - 80.7). The median time from most recent HCT to diagnosis of COVID-19 was 20 months (min - max; 0.0 - 383.9). The median time was 19.3 (0.0 - 287.6) months during 2020, 21.2 (0.1 - 324.5) months during 2021, and 19.7 (0.1 - 383.9) months during 2022 (p = NS). 145/986 (14.7%) patients died; 124 (12.6%) due to COVID-19 and 21 of other causes. Only 2/204 (1%) fully vaccinated patients died from COVID-19. There was a successive improvement in overall survival over time. In multivariate analysis, increasing age (p<.0001), worse performance status (p<.0001), contracting COVID-19 within the first 30 days (p<.0001) or 30 - 100 days after HCT (p=.003), ongoing immunosuppression (p=.004), pre-existing lung disease (p=.003), and recipient CMV seropositivity (p=.004) had negative impact on overall survival while patients contracting COVID-19 in 2020 (p<.0001) or 2021 (p=.027) had worse overall survival than patients with COVID-19 diagnosed in 2022. Discussion Although the outcome of COVID-19 has improved, patients having risk factors were still at risk for severe COVID-19 including death.
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Affiliation(s)
- Per Ljungman
- Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska Comprehensive Cancer Center, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Division of Hematology, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
- *Correspondence: Per Ljungman,
| | - Gloria Tridello
- European Society for Blood and Marrow Transplantation (EBMT) Data Office, Department of Medical Statistics & Bioinformatics, Leiden, Netherlands
| | - Jose Luis Piñana
- Hematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Fundación Investigación del Hospital Clínico de la Comunidad Valenciana (INCLIVA), Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Fabio Ciceri
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale San Raffaele, University Vita-Salute San Raffaele, Milan, Italy
| | - Henrik Sengeloev
- Department of Hematology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Alexander Kulagin
- Raisa Memorial (RM) Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russia
| | - Stephan Mielke
- Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska Comprehensive Cancer Center, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Zeynep Arzu Yegin
- Department of Hematology, Gazi University Faculty of Medicine, Ankara, Türkiye
| | - Matthew Collin
- Translational and Clinical Research Institute and The National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre, Newcastle, United Kingdom
| | - Sigrun Einardottir
- Department of Hematology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Johan Maertens
- Department of Hematology University Hospital Gasthuisberg, Leuven, Belgium
| | - Antonio Campos
- Marrow Transplant Department Inst. Português de Oncologia do Porto, Porto, Portugal
| | - Elisabetta Metafuni
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica e Ematologia, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Herbert Pichler
- St. Anna Children’s Hospital, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Frantisek Folber
- Department of Internal Medicine, Hematology and Oncology University Hospital Brno, Brno, Czechia
- Department of Internal Medicine, Hematology and Oncology Masaryk University, Brno, Czechia
| | - Carlos Solano
- European Society for Blood and Marrow Transplantation (EBMT) Data Office, Department of Medical Statistics & Bioinformatics, Leiden, Netherlands
| | - Emma Nicholson
- Haematology-oncology Unit Royal Marsden Hospital, London, United Kingdom
| | - Meltem Kurt Yüksel
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Türkiye
| | - Kristina Carlson
- Department of Hematology, Uppsala University Hospital, Uppsala, Sweden
| | - Beatriz Aguado
- Department of Hematology, Hospital Universitario de la Princesa, Madrid, Spain
| | - Caroline Besley
- University Hospitals Bristol and Weston National Health Service (NHS) Foundation Trust, Bristol, United Kingdom
| | - Jenny Byrne
- Department of Haematology Nottingham University Hospital, Nottingham, United Kingdom
| | - Immaculada Heras
- Department of Hematology, Hospital Universitario Morales Meseguer, Instituto Murciano de Investigación Biosanitaria (IMIB)-Arrixaca, Universidad de Murcia, Murcia, Spain
| | - Fiona Dignan
- Clinical Haematology Department Manchester Royal Infirmary, Manchester, United Kingdom
| | - Nicolaus Kröger
- Department of Stem cell Transplantation, University Hospital Eppendorf, Hamburg, Germany
| | - Christine Robin
- Assistance Publique-Hôpitaux de Paris (APHP), Henri Mondor Hospital, Department of Hematology, Créteil, France
| | - Anjum Khan
- Department of Haematology Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Stig Lenhoff
- Department of Hematology Skåne’s University Hospital, Lund, Sweden
| | - Anna Grassi
- Bone Marrow Transplantation Unit, Azienda Sociosanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy
| | - Veronika Dobsinska
- Department of Pediatric Hematology and Oncology, National Institute of Children’s Diseases, Comenius University, Bratislava, Slovakia
| | - Nuno Miranda
- Department of Haematology Inst. Portugues Oncologia, Lisbon, Portugal
| | - Maria-Jose Jimenez
- Department of Clinical Haematology Institut Catala d'Oncologia (ICO)-Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Ipek Yonal-Hindilerden
- Istanbul Medical Faculty, Adult Hematopoietic Stem Cell Transplant Center, Istanbul University, Istanbul, Türkiye
| | - Keith Wilson
- Blood and Bone Marrow Transplantation Department University of Cardiff, Cardiff, United Kingdom
| | - Dina Averbuch
- Pediatric Infectious Diseases Unit, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Simone Cesaro
- Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Alienor Xhaard
- Hematology-Transplantation Unit, Department of Hematology: Hôpital St. Louis, Paris, France
| | - Nina Knelange
- European Society for Blood and Marrow Transplantation (EBMT) Leiden Study Unit, European Society for Blood and Marrow Transplantation (EBMT) Data Office, Leiden, Netherlands
| | - Jan Styczynski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
| | - Malgorzata Mikulska
- Division of Infectious Diseases, University of Genoa and Ospedale Policlinico San Martino, Genova, Italy
| | - Rafael de la Camara
- Department of Hematology, Hospital Universitario de la Princesa, Madrid, Spain
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COVID-19 and blood cancer in the vaccination era. Blood 2022; 140:2763-2765. [PMID: 36580343 PMCID: PMC9906371 DOI: 10.1182/blood.2022018396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Konnova A, De Winter FHR, Gupta A, Verbruggen L, Hotterbeekx A, Berkell M, Teuwen LA, Vanhoutte G, Peeters B, Raats S, der Massen IV, De Keersmaecker S, Debie Y, Huizing M, Pannus P, Neven KY, Ariën KK, Martens GA, Bulcke MVD, Roelant E, Desombere I, Anguille S, Berneman Z, Goossens ME, Goossens H, Malhotra-Kumar S, Tacconelli E, Vandamme T, Peeters M, van Dam P, Kumar-Singh S. Predictive model for BNT162b2 vaccine response in cancer patients based on blood cytokines and growth factors. Front Immunol 2022; 13:1062136. [PMID: 36618384 PMCID: PMC9813584 DOI: 10.3389/fimmu.2022.1062136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Background Patients with cancer, especially hematological cancer, are at increased risk for breakthrough COVID-19 infection. So far, a predictive biomarker that can assess compromised vaccine-induced anti-SARS-CoV-2 immunity in cancer patients has not been proposed. Methods We employed machine learning approaches to identify a biomarker signature based on blood cytokines, chemokines, and immune- and non-immune-related growth factors linked to vaccine immunogenicity in 199 cancer patients receiving the BNT162b2 vaccine. Results C-reactive protein (general marker of inflammation), interleukin (IL)-15 (a pro-inflammatory cytokine), IL-18 (interferon-gamma inducing factor), and placental growth factor (an angiogenic cytokine) correctly classified patients with a diminished vaccine response assessed at day 49 with >80% accuracy. Amongst these, CRP showed the highest predictive value for poor response to vaccine administration. Importantly, this unique signature of vaccine response was present at different studied timepoints both before and after vaccination and was not majorly affected by different anti-cancer treatments. Conclusion We propose a blood-based signature of cytokines and growth factors that can be employed in identifying cancer patients at persistent high risk of COVID-19 despite vaccination with BNT162b2. Our data also suggest that such a signature may reflect the inherent immunological constitution of some cancer patients who are refractive to immunotherapy.
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Affiliation(s)
- Angelina Konnova
- Molecular Pathology Group, Laboratory of Cell Biology & Histology, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium,Laboratory of Medical Microbiology, Vaccine and Infectious disease Institute, University of Antwerp, Wilrijk, Belgium
| | - Fien H. R. De Winter
- Molecular Pathology Group, Laboratory of Cell Biology & Histology, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Akshita Gupta
- Molecular Pathology Group, Laboratory of Cell Biology & Histology, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium,Laboratory of Medical Microbiology, Vaccine and Infectious disease Institute, University of Antwerp, Wilrijk, Belgium
| | - Lise Verbruggen
- Multidisciplinary Oncological Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium
| | - An Hotterbeekx
- Molecular Pathology Group, Laboratory of Cell Biology & Histology, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Matilda Berkell
- Molecular Pathology Group, Laboratory of Cell Biology & Histology, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium,Laboratory of Medical Microbiology, Vaccine and Infectious disease Institute, University of Antwerp, Wilrijk, Belgium
| | - Laure-Anne Teuwen
- Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Wilrijk, Belgium
| | - Greetje Vanhoutte
- Multidisciplinary Oncological Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium,Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Wilrijk, Belgium
| | - Bart Peeters
- Department of Laboratory Medicine, Antwerp University Hospital, Edegem, Belgium
| | - Silke Raats
- Multidisciplinary Oncological Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium
| | - Isolde Van der Massen
- Multidisciplinary Oncological Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium
| | - Sven De Keersmaecker
- Multidisciplinary Oncological Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium
| | - Yana Debie
- Multidisciplinary Oncological Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium,Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Wilrijk, Belgium
| | - Manon Huizing
- Biobank, Antwerp University Hospital, Edegem, Belgium
| | - Pieter Pannus
- Scientific Directorate Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Kristof Y. Neven
- Scientific Directorate Epidemiology and Public Health, Sciensano, Brussels, Belgium,Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium,Federal Public Service (FPS) Health, Food Chain Safety and Environment, Brussels, Belgium
| | - Kevin K. Ariën
- Virology Unit, Institute of Tropical Medicine Antwerp, Antwerp, Belgium,Department of Biomedical Sciences, University of Antwerp, Edegem, Belgium
| | - Geert A. Martens
- Department of Laboratory Medicine, AZ Delta General Hospital, Roeselare, Belgium
| | - Marc Van Den Bulcke
- Scientific Directorate Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Ella Roelant
- Clinical Trial Center (CTC), Clinical Research Centre (CRC) Antwerp, Antwerp University Hospital, University of Antwerp, Edegem, Belgium,StatUa, Center for Statistics, University of Antwerp, Antwerp, Belgium
| | - Isabelle Desombere
- Service Immune response, Scientific Directorate Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Sébastien Anguille
- Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Wilrijk, Belgium
| | - Zwi Berneman
- Multidisciplinary Oncological Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium,Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Wilrijk, Belgium
| | - Maria E. Goossens
- Scientific Directorate Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Herman Goossens
- Laboratory of Medical Microbiology, Vaccine and Infectious disease Institute, University of Antwerp, Wilrijk, Belgium
| | - Surbhi Malhotra-Kumar
- Laboratory of Medical Microbiology, Vaccine and Infectious disease Institute, University of Antwerp, Wilrijk, Belgium
| | - Evelina Tacconelli
- Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Timon Vandamme
- Multidisciplinary Oncological Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium,Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Wilrijk, Belgium
| | - Marc Peeters
- Multidisciplinary Oncological Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium,Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Wilrijk, Belgium
| | - Peter van Dam
- Multidisciplinary Oncological Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium,Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Wilrijk, Belgium
| | - Samir Kumar-Singh
- Molecular Pathology Group, Laboratory of Cell Biology & Histology, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium,Laboratory of Medical Microbiology, Vaccine and Infectious disease Institute, University of Antwerp, Wilrijk, Belgium,*Correspondence: Samir Kumar-Singh,
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