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

• Authors: DOESUM Jaap A van; SALMANTON-GARCIA Jon; MARCHESI Francesco; ROBERTA Di Blasi; FALCES-ROMERO Iker; CABIRTA Alba; FARINA Francesca; BESSON Caroline; WEINBERGEROVÁ Barbora; JENS Van Praet; SCHOENLEIN Martin; LOPEZ-GARCIA Alberto; LAMURE Sylvain; GUIDETTI Anna; CRISTINA De Ramon-Sanchez; BATINIC Josip; GAVRIILAKI Eleni; TRAGIANNIDIS Athanasios; TISI Maria Chiara; PLANTEFEVE Gaetan; PETZER Verena; ORMAZABAL-VELEZ Irati; MARQUES de Almeida Joyce; MARCHETTI Monia; MAERTENS Johan; MACHADO Marina; KULASEKARARAJ Austin; HERNANDEZ-RIVAS Jose-angel; SILVA Maria Gomes da; FERNANDEZ Noemi; ESPIGADO Ildefonso; DRGONA Lubos; DRAGONETTI Giulia; METAFUNI Elisabetta; CALBACHO Maria; BLENNOW Ola; WOLF Dominik; BJORN van Anrooij; RODRIGUES Raquel Nunes; NORDLANDER Anna; MARTIN-GONZALEZ Juan-Alberto; LIEVIN Raphael; JIMENEZ Moraima; GRAFE Stefanie K; GARCIA-SANZ Ramon; CORDOBA Raul; RAHIMLI Laman; TOM van Meerten; CORNELY Oliver A; PAGANO Livio
• Year of publication: 2023
• Type: Article in Periodical
• Magazine / Source: Blood advances
• MU Faculty or unit: Faculty of Medicine
• Web: https://ashpublications.org/bloodadvances/article/7/11/2645/495340/Impact-of-SARS-CoV-2-vaccination-and-monoclonal
• Doi: http://dx.doi.org/10.1182/bloodadvances.2022009578
• Keywords: SARS-CoV-2 vaccination; post–CD19-directed CAR T-cell therapy
• Description: 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.