Anne Mea Spanjaart, Per Ljungman, Gloria Tridello, Juana Schwartz, Nuria Martinez-Cibrián, Pere Barba, Mi Kwon, Lucia Lopez-Corral, Joaquin Martinez-Lopez, Christelle Ferra, Roberta Di Blasi, Hervé Ghesquieres, Pim Mutsaers, Friso Calkoen, Margot Jak, Jaap van Doesum, Joost S. P. Vermaat, Marjolein van der Poel, Johan Maertens, Massimiliano Gambella, Elisabetta Metafuni, Fabio Ciceri, Riccardo Saccardi, Emma Nicholson, Eleni Tholouli, Collin Matthew, Victoria Potter, Adrian Bloor, Caroline Besley, Claire Roddie, Keith Wilson, Arnon Nagler, Antonio Campos, Soeren Lykke Petersen, Frantisek Folber, Peter Bader, Jurgen Finke, Nicolaus Kroger, Nina Knelange, Rafael de La Camara, Marie José Kersten, Stephan Mielke
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Vermaat, Marjolein van der Poel, Johan Maertens, Massimiliano Gambella, Elisabetta Metafuni, Fabio Ciceri, Riccardo Saccardi, Emma Nicholson, Eleni Tholouli, Collin Matthew, Victoria Potter, Adrian Bloor, Caroline Besley, Claire Roddie, Keith Wilson, Arnon Nagler, Antonio Campos, Soeren Lykke Petersen, Frantisek Folber, Peter Bader, Jurgen Finke, Nicolaus Kroger, Nina Knelange, Rafael de La Camara, Marie José Kersten, Stephan Mielke","doi":"10.1038/s41375-024-02336-1","DOIUrl":null,"url":null,"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. 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引用次数: 0
摘要
在接受嵌合抗原受体(CAR)T 细胞疗法治疗血液恶性肿瘤的患者中,COVID-19 与高死亡率有关。在此,我们以评估 2022 年 Omicron 期间 COVID-19 导致的死亡率为主要目标,调查了随着时间的推移,该结果是否有所改善。这项多中心研究使用 EBMT 开发的 MED-A 和 COVID-19 报告表收集数据。共有 188 名患者被纳入分析,其中 39 人在 2020 年确诊,35 人在 2021 年确诊,106 人在 2022 年确诊。中位年龄为 58.9 岁(最小-最大:5.2-78.4 岁)。随着时间的推移,COVID-19 相关死亡率持续下降(2020 年:43.6%;2021 年:22.9%;2022 年:7.5%),在多变量分析中,感染年份是预测生存率的最有力因素(p = 0.0001)。将 2022 年与 2020-2021 年相比,出现下呼吸道症状(21.7% vs 37.8%,p = 0.01)、需要氧气支持(25.5% vs 43.2%,p = 0.01)或入住重症监护室(5.7% vs 33.8%,p = 0.0001)的患者显著减少。尽管随着时间的推移,COVID-19 相关死亡率有所下降,但 CAR T 细胞受者发生并发症的风险仍高于普通人群。因此,建议继续对接受 B 细胞靶向 CAR T 细胞治疗的患者进行 COVID-19 的警惕性监测,以确保最佳的感染预防效果,并在必要时进行先进的治疗。
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
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.
期刊介绍:
Title: Leukemia
Journal Overview:
Publishes high-quality, peer-reviewed research
Covers all aspects of research and treatment of leukemia and allied diseases
Includes studies of normal hemopoiesis due to comparative relevance
Topics of Interest:
Oncogenes
Growth factors
Stem cells
Leukemia genomics
Cell cycle
Signal transduction
Molecular targets for therapy
And more
Content Types:
Original research articles
Reviews
Letters
Correspondence
Comments elaborating on significant advances and covering topical issues