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

Spanjaart, Anne Mea; Ljungman, Per; Tridello, Gloria; Schwartz, Juana; Martinez-Cibrian, Nuria; Barba, Pere; Kwon, Mi; Lopez-Corral, Lucia; Martinez-Lopez, Joaquin; Ferra, Christelle; Di Blasi, Roberta; Ghesquieres, Herve; Mutsaers, Pim; Calkoen, Friso; Jak, Margot; van Doesum, Jaap; Vermaat, Joost SP; van der Poel, Marjolein; Maertens, Johan; Gambella, Massimiliano; Metafuni, Elisabetta; Ciceri, Fabio; Saccardi, Riccardo; Nicholson, Emma; Tholouli, Eleni; Matthew, Collin; Potter, Victoria; Bloor, Adrian; Besley, Caroline; Roddie, Claire; Wilson, Keith; Nagler, Arnon; Campos, Antonio; Petersen, Soeren Lykke; Folber, Frantisek; Bader, Peter; Finke, Jurgen; Kroger, Nicolaus; Knelange, Nina; de la Camara, Rafael; Kersten, Marie Jose; Mielke, Stephan

doi:10.1038/s41375-024-02336-1

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

Author:

Spanjaart, Anne Mea

Ljungman, Per ; Tridello, Gloria ; Schwartz, Juana ; Martinez-Cibrian, Nuria ; Barba, Pere ; Kwon, Mi ; Lopez-Corral, Lucia ; Martinez-Lopez, Joaquin ; Ferra, Christelle ; Di Blasi, Roberta ; Ghesquieres, Herve ; Mutsaers, Pim ; Calkoen, Friso ; Jak, Margot ; van Doesum, Jaap ; Vermaat, Joost SP ; van der Poel, Marjolein ; Maertens, Johan ; Gambella, Massimiliano ; Metafuni, Elisabetta ; Ciceri, Fabio ; Saccardi, Riccardo ; Nicholson, Emma ; Tholouli, Eleni ; Matthew, Collin ; Potter, Victoria ; Bloor, Adrian ; Besley, Caroline ; Roddie, Claire ; Wilson, Keith ; Nagler, Arnon ; Campos, Antonio ; Petersen, Soeren Lykke ; Folber, Frantisek ; Bader, Peter ; Finke, Jurgen ; Kroger, Nicolaus ; Knelange, Nina ; de la Camara, Rafael ; Kersten, Marie Jose ; Mielke, Stephan

Keywords:

Science & Technology, Life Sciences & Biomedicine, Oncology, Hematology, VACCINATION, SARS-COV-2, Humans, COVID-19, Middle Aged, Male, Aged, Female, Adult, Immunotherapy, Adoptive, SARS-CoV-2, Young Adult, Adolescent, Child, Hematologic Neoplasms, Child, Preschool, Europe, Treatment Outcome, Receptors, Chimeric Antigen, Survival Rate, 1103 Clinical Sciences, 1112 Oncology and Carcinogenesis, Immunology, 3201 Cardiovascular medicine and haematology, 3202 Clinical sciences, 3211 Oncology and carcinogenesis

Abstract:

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.