[Prophylactic efficacy of tixagevimab/cilgavimab in patients with hematological neoplasms: a single-center study].

[Rinsho ketsueki] The Japanese journal of clinical hematology Pub Date : 2025-01-01 DOI:10.11406/rinketsu.66.3

Hirofumi Nakano, Shiori Nakashima, Yui Imai, Tomoyuki Uchida, Morihiro Inoue, Masao Hagihara

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Abstract

We retrospectively analyzed the efficacy of tixagevimab/cilgavimab (Tix/Cil) in 142 patients (total of 157 injections) with hematological disorders. Fifteen patients (9.5%) were infected with coronavirus disease (COVID-19), and 3 of these remained infected even after repeated administration of Tix/Cil. Malignant lymphoma and multiple myeloma were the most frequent underlying disorders (frequencies of 18.9% and 17.5%, respectively). Whole genome sequencing of the Omicron variant was performed in 11 patients, and revealed sensitivity to Tix/Cil in only 2. In both cases, the severity of COVID-19 was moderate I or II. Since April 2023, when a Tix/Cil-resistant variant became dominant (frequency >70%), the incidence of breakthrough infections increased from 4% to 35%, and none responded to Tix/Cil. Vaccination, together with daily precautions against infection, is the current approach used to prevent COVID-19, particularly in patients with lymphoid malignancies, because Tix/Cil is no longer effective as prophylaxis.

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[替沙吉维单/西加维单对血液肿瘤患者的预防作用：一项单中心研究]。

我们回顾性分析了142例血液病患者（共157次注射）使用替沙吉维单抗/cilgavimab （Tix/Cil）的疗效。15例患者（9.5%）感染了冠状病毒病（COVID-19），其中3例患者在多次使用Tix/Cil后仍然感染。恶性淋巴瘤和多发性骨髓瘤是最常见的基础疾病（频率分别为18.9%和17.5%）。在11例患者中进行了Omicron变体的全基因组测序，仅2例患者显示对Tix/Cil敏感。在这两种情况下，COVID-19的严重程度都是中度I或II。自2023年4月以来，当Tix/Cil耐药变体成为主导（频率为70%）时，突破性感染的发生率从4%增加到35%，并且没有对Tix/Cil产生反应。疫苗接种和日常预防感染是目前预防COVID-19的方法，特别是在淋巴系统恶性肿瘤患者中，因为Tix/Cil不再是有效的预防方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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[Rinsho ketsueki] The Japanese journal of clinical hematology

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