Improved outcome of COVID-19 over time in patients treated with CAR T-cell therapy: Update of the European COVID-19 multicenter study on behalf of the European Society for Blood and Marrow Transplantation (EBMT) Infectious Diseases Working Party (IDWP) and the European Hematology Association (EHA) Lymphoma Group
Por:
Spanjaart, AM, Ljungman, P, Tridello, G, Schwartz, J, Martinez-Cibrian, N, Barba, P, Kwon, M, Lopez-Corral, L, Martinez-Lopez, J, Ferra, C, Di Blasi, R, Ghesquieres, H, Mutsaers, P, Calkoen, F, Jak, M, van Doesum, J, Vermaat, JSP, van der Poel, M, Maertens, J, Gambella, M, Metafuni, E, Ciceri, F, Saccardi, R, Nicholson, E, Tholouli, E, Matthew, C, Potter, V, Bloor, A, Besley, C, Roddie, C, Wilson, K, Nagler, A, Campos, A, Petersen, SL, Folber, F, Bader, P, Finke, J, Kroger, N, Knelange, N, de la Camara, R, Kersten, MJ and Mielke, S
Publicada:
1 sep 2024
Ahead of Print:
1 jul 2024
Resumen:
COVID-19 has been associated with high mortality in patients treated with Chimeric Antigen Receptor (CAR) T-cell therapy for hematologic malignancies. Here, we investigated whether the outcome has improved over time with the primary objective of assessing COVID-19-attributable mortality in the Omicron period of 2022 compared to previous years. Data for this multicenter study were collected using the MED-A and COVID-19 report forms developed by the EBMT. One-hundred-eighty patients were included in the analysis, 39 diagnosed in 2020, 35 in 2021 and 106 in 2022. The median age was 58.9 years (min-max: 5.2-78.4). There was a successive decrease in COVID-19-related mortality over time (2020: 43.6%, 2021: 22.9%, 2022: 7.5%) and in multivariate analysis year of infection was the strongest predictor of survival (p = 0.0001). Comparing 2022 with 2020-2021, significantly fewer patients had lower respiratory symptoms (21.7% vs 37.8%, p = 0.01), needed oxygen support (25.5% vs 43.2%, p = 0.01), or were admitted to ICU (5.7% vs 33.8%, p = 0.0001). Although COVID-19-related mortality has decreased over time, CAR T-cell recipients remain at higher risk for complications than the general population. Consequently, vigilant monitoring for COVID-19 in patients undergoing B-cell-targeting CAR T-cell treatment is continuously recommended ensuring optimal prevention of infection and advanced state-of-the art treatment when needed.
Filiaciones:
Spanjaart, AM:
Univ Amsterdam, Canc Ctr Amsterdam, Dept Hematol, Amsterdam UMC Locat, Amsterdam, Netherlands
LYMMCARE, Amsterdam, Netherlands
Ljungman, P:
Karolinska Univ Hosp Huddinge, Dept Cellular Therapy & Allogene Stem Cell Transpl, Stockholm, Sweden
Karolinska Comprehens Canc Ctr, Stockholm, Sweden
Tridello, G:
European Soc Blood & Marrow Transplantat EBMT, Dept Med Stat & Bioinformat, Data Off, Leiden, Netherlands
Schwartz, J:
European Soc Blood & Marrow Transplantat EBMT, Leiden Study Unit, Data Off, Leiden, Netherlands
Martinez-Cibrian, N:
Hosp Clin Barcelona, Dept Hematol, Barcelona, Spain
Barba, P:
Vall dHebron Univ Hosp, Dept Hematol, Barcelona, Spain
Kwon, M:
Hosp G Univ Gregorio Maranon, Inst Hlth Res Gregorio Maranon, Dept Hematol, Madrid, Spain
Lopez-Corral, L:
Hosp Univ Salamanca, Dept Hematol, Salamanca, Spain
IBSAL, Salamanca, Spain
Martinez-Lopez, J:
Univ Complutense Madrid, Hosp Univ 12 Octubre, Dept Hematol, CNIO, Madrid, Spain
:
Hosp Germans Trias i Pujol, Catalan Inst Oncol, Josep Carreras Res Inst, Clin Hematol Dept, Barcelona, Spain
Di Blasi, R:
Hop St Louis, Assistance Publ Hop Paris, Dept Hematol, Paris, France
Ghesquieres, H:
Lyon Sud Hosp, Hosp Civils Lyon, Dept Hematol, Pierre Benite, France
Mutsaers, P:
Erasmus MC Canc Ctr, Dept Hematol, Rotterdam, Netherlands
Calkoen, F:
Princess Maxima Ctr Pediat Oncol, Utrecht, Netherlands
Jak, M:
Univ Med Ctr Utrecht, Dept Hematol, Utrecht, Netherlands
van Doesum, J:
Univ Groningen, Univ Med Ctr Groningen, Dept Hematol, Groningen, Netherlands
Vermaat, JSP:
Leiden Univ, Med Ctr, Dept Hematol, Leiden, Netherlands
van der Poel, M:
Maastricht Univ, GROW Sch Oncol & Dev Biol, Dept Hematol, Dept Internal Med,Div Hematol,Med Ctr, Maastricht, Netherlands
Maertens, J:
Univ Hosp Gasthuisberg, Dept Hematol, Leuven, Belgium
Gambella, M:
IRCCS Osped Policlin San Martino, Dept Hematol & Cellular Therapy, Genoa, Italy
Metafuni, E:
Fdn Policlin Univ Agostino Gemelli IRCCS, Dipartimento Diagnost Immagini Radioterapia Oncol, Rome, Italy
Ciceri, F:
IRCCS San Raffaele Sci Inst, Hematol & BMT Unit, Milan, Italy
Saccardi, R:
Azienda Osped Univ Careggi, Cell Therapy & Transfus Med Unit, Florence, Italy
Nicholson, E:
Royal Marsden Hosp, Dept Haematol, London, England
Tholouli, E:
Manchester Univ NHS Fdn Trust, Manchester Royal Infirm, Dept Clin Haematol, Manchester, England
Matthew, C:
Northern Ctr Bone Marrow Transplantat, Adult HSCT Unit, Newcastle Upon Tyne, England
Potter, V:
Kings Coll Hosp NHS Fdn Trust, Dept Haematol Med, Denmark Hill, London, England
Bloor, A:
Univ Manchester, Christie Hosp NHS Fdn Trust, Adult Leukaemia & Bone Marrow Transplant Unit, Manchester, England
Besley, C:
Univ Hosp Bristol & Weston NHSFT, Dept Haematol, Bristol, England
Roddie, C:
Univ Coll London Hosp, Dept Haematol, London, England
Wilson, K:
Univ Hosp Cardiff, Blood & Bone Marrow Transplantat Dept, Cardiff, Wales
Nagler, A:
Tel Aviv Univ, Chaim Sheba Med Ctr, Tel Hashomer, Israel
Campos, A:
EPE, Inst Portugues Oncol Porto, Celular Therapy Dept, Porto, Portugal
Petersen, SL:
Copenhagen Univ Hosp, Dept Hematol, Rigshosp, Copenhagen, Denmark
Folber, F:
Masaryk Univ Hosp Brno, Dept internal Med Hematol & Oncol, Brno, Czech Republic
Bader, P:
Goethe Univ, Univ Hosp Frankfurt, Dept Children & Adolescents, Div Stem Cell Transplantat & Immunol, Frankfurt, Germany
Finke, J:
Univ Freiburg, Fac Med, Dept Hematol Oncol & Stem Cell Transplantat, Freiburg, Germany
Univ Freiburg, Med Ctr, Freiburg, Germany
Kroger, N:
Univ Hosp Eppendorf, Dept Stem Cell Transplantat, Hamburg, Germany
Knelange, N:
European Soc Blood & Marrow Transplantat EBMT, Leiden Study Unit, Data Off, Leiden, Netherlands
de la Camara, R:
Hosp Univ La Princesa, Dept Hematol, Madrid, Spain
Kersten, MJ:
Univ Amsterdam, Canc Ctr Amsterdam, Dept Hematol, Amsterdam UMC Locat, Amsterdam, Netherlands
LYMMCARE, Amsterdam, Netherlands
Mielke, S:
Karolinska Inst, Dept Cellular Therapy & Allogene Stem Cell Transpl, Dept Lab Med, Stockholm, Sweden
Univ Hosp, Karolinska Comprehens Canc Ctr, Karolinska ATMP Ctr, Stockholm, Sweden
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