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

  • Jaap A van Doesum (Shared first author)
  • Jon Salmanton-García (Shared first author)
  • Francesco Marchesi
  • Roberta Di Blasi
  • Iker Falces-Romero
  • Alba Cabirta
  • Francesca Farina
  • Caroline Besson
  • Barbora Weinbergerová
  • Jens Van Praet
  • Martin Schönlein
  • Alberto Lopez-Garcia
  • Sylvain Lamure
  • Anna Guidetti
  • Cristina De Ramón-Sánchez
  • Josip Batinic
  • Eleni Gavriilaki
  • Athanasios Tragiannidis
  • Maria Chiara Tisi
  • Gaëtan Plantefeve
  • Verena Petzer
  • Irati Ormazabal-Velez
  • Joyce Marques de Almeida
  • Monia Marchetti
  • Johan A Maertens
  • Marina Machado
  • Austin G Kulasekararaj
  • José Ángel Hernández-Rivas
  • Maria Gomes da Silva
  • Noemí Fernández
  • Ildefonso Espigado
  • Lubos Drgona
  • Giulia Dragonetti
  • Elisabetta Metafuni
  • Maria Calbacho
  • Ola Blennow
  • Dominik Wolf
  • Bjorn van Anrooij
  • Raquel Nunes Rodrigues
  • Anna Nordlander
  • Juan-Alberto Martín-González
  • Raphaël Lievin
  • Moraima Jiménez
  • Stefanie K Grafe
  • Ramon Garcia-Sanz
  • Raúl Córdoba
  • Laman Rahimli
  • Tom van Meerten
  • Oliver A Cornely
  • Livio Pagano

Related Research units

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.

Bibliographical data

Original languageEnglish
ISSN2473-9529
DOIs
Publication statusPublished - 13.06.2023

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Copyright © 2023 American Society of Hematology.

PubMed 37058479