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van Doesum JA, Salmanton-García J, Marchesi F, Di Blasi R, Falces-Romero I, Cabirta A, Farina F, Besson C, Weinbergerová B, Van Praet J, Schönlein M, Lopez-Garcia A, Lamure S, Guidetti A, De Ramón-Sánchez C, Batinic J, Gavriilaki E, Tragiannidis A, Tisi MC, Plantefeve G, Petzer V, Ormazabal-Velez I, Marques de Almeida J, Marchetti M, Maertens JA, Machado M, Kulasekararaj AG, Hernández-Rivas JÁ, Gomes da Silva M, Fernández N, Espigado I, Drgona L, Dragonetti G, Metafuni E, Calbacho M, Blennow O, Wolf D, van Anrooij B, Nunes Rodrigues R, Nordlander A, Martín-González JA, Lievin R, Jiménez M, Grafe SK, Garcia-Sanz R, Córdoba R, Rahimli L, van Meerten T, Cornely OA, Pagano L. Impact of SARS-CoV-2 vaccination and monoclonal antibodies on outcome post CD19-CAR-T: an EPICOVIDEHA survey. Blood Adv 2023:495340. [PMID: 37058479 PMCID: PMC10112941 DOI: 10.1182/bloodadvances.2022009578] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/28/2023] [Accepted: 03/30/2023] [Indexed: 04/15/2023] Open
Abstract
Patients with previous CD19 directed chimeric antigen receptor T cell therapy (CAR T)-cell therapy have a prolonged vulnerability to viral infections. Coronavirus diseases 2019 (COVID-19) has a great impact and has previously been shown to cause high mortality in this population. Until now, real world data of the impact of vaccination and treatment on patients with COVID-19 after CD19 directed CAR T-cell therapy are lacking. Therefore, this multicenter retrospective study was conducted with data from the EPICOVIDEHA survey. Sixty-four patients were identified. The overall mortality caused by COVID-19 was 31%. Patients infected with the Omicron variant had a significantly lower risk of death due to COVID-19 compared to patients infected with previous variants (7% versus 58% (P=0.012)). Twenty-six patients were vaccinated at time of COVID-19 diagnosis. Two vaccinations showed marked but unsignificant reduction risk of COVID-19 caused mortality (33.3% versus 14.2% (P=0.379)).Also the course of disease appears milder with less frequent ICU admissions (39% versus 14% (P=0.054)) and shorter duration of hospitalization (7 versus 27.5 days (P=0.022)). Of the available treatment options, only monoclonal antibodies seemed to be effectively reducing mortality from 32% to zero (P=0.036). We conclude that survival rates of CAR T-cell recipients with COVID-19 improved over time and that the combination of prior vaccination and monoclonal antibody treatment significantly reduces their risk of death.
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Affiliation(s)
- Jaap A van Doesum
- University Medical Center Groningen, Groningen, the Netherlands, Groningen, Netherlands
| | | | | | | | | | - 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, Passeig Vall d'Hebron 119, Barcelona, Spain
| | | | | | | | - Jens Van Praet
- AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium, Brugge, Belgium
| | - Martin Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, Hamburg, Germany
| | - Alberto Lopez-Garcia
- Department of Hematology, Health Research Institute IIS-FJD, Fundacion Jimenez Diaz University Hospital, Madrid, Spain., Madrid, Spain
| | | | - Anna Guidetti
- Fondazione IRCCS Istituto Nazionale dei Tumori Milano, Milano, Italy
| | | | - Josip Batinic
- University Hospital Centre Zagreb, Zagreb, Croatia, Zagreb, Croatia, Republic of
| | | | | | | | - Gaëtan Plantefeve
- Centre Hospitalier d'Argenteuil, Argenteuil, France, Centre Hospitalier d'Argenteuil, Argenteuil, France, France
| | | | | | | | - Monia Marchetti
- Az Osp SS Antonio e Biagio e Cesare Arrigo, Alessandria, Alessandria, Italy
| | | | - Marina Machado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | | | | | - Noemí Fernández
- Hospital Universitario Marqués de Valdecilla de Santander, SANTANDER, Spain
| | - Ildefonso Espigado
- University Hospital Virgen Macarena / University Hospital Virgen del Rocío, Seville., Sevilla, Spain
| | - Lubos Drgona
- Oncohematology Clinic, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovak Republic
| | - Giulia Dragonetti
- Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | - Elisabetta Metafuni
- Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, Rome, Idaho, Italy
| | | | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Dominik Wolf
- Medical University of Innsbruck, Innsbruck, Austria
| | - Bjorn van Anrooij
- University Medical Center Groningen, University of Groningen,, Groningen, Netherlands
| | - Raquel Nunes Rodrigues
- Departamento de Hematologia, Instituto Português de Oncologia, Lisboa, Portugal, Lisbon, Portugal
| | - Anna Nordlander
- Department of Infectious Diseases, Karolinska University Hospital,, stockholm, Sweden
| | | | | | - Moraima Jiménez
- Servei d'Hematologia, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | | | | | - Raúl Córdoba
- Department of Hematology, Health Research Institute IIS-FJD, Fundacion Jimenez Diaz University Hospital, Madrid, Spain., Madrid, Spain
| | - Laman Rahimli
- "University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany University of Cologne,, Köln, Germany
| | | | | | - Livio Pagano
- Hematology, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy, Rome, Italy
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