Portal de Periódicos da CAPES

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

2023; Elsevier BV; Volume: 7; Issue: 11 Linguagem: Inglês

10.1182/bloodadvances.2022009578

2473-9537

Jaap A. van Doesum, Jon Salmanton‐García, Francesco Marchesi, Roberta Di Blasi, Iker Falces‐Romero, Alba Cabirta, Francesca Farina, Caroline Besson, Barbora Weinbergerová, Jens Van Praet, Martin Schönlein, Alberto López‐García, Sylvain Lamure, Anna Guidetti, Cristina de Ramón, Josip Batinić, Eleni Gavriilaki, Athanasios Tragiannidis, Maria Chiara Tisi, Gaëtan Plantefève, Verena Petzer, Irati Ormazabal‐Vélez, Joyce Marques de Almeida, Monia Marchetti, Johan Maertens, Marina Machado, Austin Kulasekararaj, José‐Ángel Hernández‐Rivas, María Gomes da Silva, Noemí Fernández, Ildefonso Espigado, Ľuboš Drgoňa, Giulia Dragonetti, Elisabetta Metafuni, María Calbacho, Ola Blennow, Dominik Wolf‎, Björn van Anrooij, Raquel Nunes Rodrigues, Anna Nordlander, Juan-Alberto Martín-González, Raphaël Liévin, Moraima Jiménez, Stefanie K. Gräfe, Ramón García‐Sánz, Raúl Córdoba, Laman Rahimli, Tom van Meerten, Oliver A. Cornely, Livio Pagano,

Biomedical and Engineering Education

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.