Article ; Online: Impact of SARS-CoV-2 vaccination and monoclonal antibodies on outcome post-CD19-directed CAR T-cell therapy: an EPICOVIDEHA survey.
2023 Volume 7, Issue 11, Page(s) 2645–2655
Abstract: Patients with previous CD19-directed chimeric antigen receptor (CAR) T-cell therapy have a prolonged vulnerability to viral infections. Coronavirus disease 2019 (COVID-19) has a great impact and has previously been shown to cause high mortality in this ... ...
| Abstract | Patients with previous CD19-directed chimeric antigen receptor (CAR) T-cell therapy have a prolonged vulnerability to viral infections. Coronavirus disease 2019 (COVID-19) has a great impact and has previously been shown to cause high mortality in this population. Until now, real-world data on 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 with patients infected with previous variants (7% vs 58% [P = .012]). Twenty-six patients were vaccinated at the time of the COVID-19 diagnosis. Two vaccinations showed a marked but unsignificant reduction in the risk of COVID-19-caused mortality (33.3% vs 14.2% [P = .379]). In addition, the course of the disease appears milder with less frequent intensive care unit admissions (39% vs 14% [P = .054]) and a shorter duration of hospitalization (7 vs 27.5 days [P = .022]). Of the available treatment options, only monoclonal antibodies seemed to be effective at reducing mortality from 32% to 0% (P = .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. This trial was registered at www.clinicaltrials.gov as #NCT04733729. |
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| MeSH term(s) | Humans ; COVID-19/therapy ; COVID-19 Testing ; COVID-19 Vaccines ; Immunotherapy, Adoptive ; Retrospective Studies ; SARS-CoV-2 ; Vaccination ; Adaptor Proteins, Signal Transducing ; Antibodies, Monoclonal ; Antigens, CD19 |
| Chemical Substances | COVID-19 Vaccines ; Adaptor Proteins, Signal Transducing ; Antibodies, Monoclonal ; Antigens, CD19 |
| Language | English |
| Publishing date | 2023-04-14 |
| Publishing country | United States |
| Document type | Multicenter Study ; Journal Article |
| ZDB-ID | 2915908-8 |
| ISSN | 2473-9537 ; 2473-9529 |
| ISSN (online) | 2473-9537 |
| ISSN | 2473-9529 |
| DOI | 10.1182/bloodadvances.2022009578 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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