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Blood Adv . Impact of SARS-CoV-2 vaccination and monoclonal antibodies on outcome post CD19-CAR-T: an EPICOVIDEHA survey

tetano

Editor, Senior Moderator
Blood Adv


. 2023 Apr 14;bloodadvances.2022009578.
doi: 10.1182/bloodadvances.2022009578. Online ahead of print.
Impact of SARS-CoV-2 vaccination and monoclonal antibodies on outcome post CD19-CAR-T: an EPICOVIDEHA survey


Jaap A van Doesum[SUP] 1 [/SUP], Jon Salmanton-García[SUP] 2 [/SUP], Francesco Marchesi[SUP] 3 [/SUP], Roberta Di Blasi[SUP] 4 [/SUP], Iker Falces-Romero[SUP] 5 [/SUP], Alba Cabirta[SUP] 6 [/SUP], Francesca Farina[SUP] 7 [/SUP], Caroline Besson[SUP] 8 [/SUP], Barbora Weinbergerová[SUP] 9 [/SUP], Jens Van Praet[SUP] 10 [/SUP], Martin Schönlein[SUP] 11 [/SUP], Alberto Lopez-Garcia[SUP] 12 [/SUP], Sylvain Lamure[SUP] 13 [/SUP], Anna Guidetti[SUP] 14 [/SUP], Cristina De Ramón-Sánchez[SUP] 15 [/SUP], Josip Batinic[SUP] 16 [/SUP], Eleni Gavriilaki[SUP] 17 [/SUP], Athanasios Tragiannidis[SUP] 18 [/SUP], Maria Chiara Tisi[SUP] 19 [/SUP], Gaëtan Plantefeve[SUP] 20 [/SUP], Verena Petzer[SUP] 21 [/SUP], Irati Ormazabal-Velez[SUP] 22 [/SUP], Joyce Marques de Almeida[SUP] 23 [/SUP], Monia Marchetti[SUP] 24 [/SUP], Johan A Maertens[SUP] 25 [/SUP], Marina Machado[SUP] 26 [/SUP], Austin G Kulasekararaj[SUP] 27 [/SUP], José Ángel Hernández-Rivas[SUP] 28 [/SUP], Maria Gomes da Silva[SUP] 29 [/SUP], Noemí Fernández[SUP] 30 [/SUP], Ildefonso Espigado[SUP] 31 [/SUP], Lubos Drgona[SUP] 32 [/SUP], Giulia Dragonetti[SUP] 33 [/SUP], Elisabetta Metafuni[SUP] 34 [/SUP], Maria Calbacho[SUP] 35 [/SUP], Ola Blennow[SUP] 36 [/SUP], Dominik Wolf[SUP] 37 [/SUP], Bjorn van Anrooij[SUP] 38 [/SUP], Raquel Nunes Rodrigues[SUP] 39 [/SUP], Anna Nordlander[SUP] 40 [/SUP], Juan-Alberto Martín-González[SUP] 41 [/SUP], Raphaël Lievin[SUP] 42 [/SUP], Moraima Jiménez[SUP] 43 [/SUP], Stefanie K Grafe[SUP] 44 [/SUP], Ramon Garcia-Sanz[SUP] 45 [/SUP], Raúl Córdoba[SUP] 12 [/SUP], Laman Rahimli[SUP] 46 [/SUP], Tom van Meerten[SUP] 47 [/SUP], Oliver A Cornely[SUP] 48 [/SUP], Livio Pagano[SUP] 49 [/SUP]



Affiliations

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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