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

• Published in: Leukemia Vol. 38; no. 9; pp. 1985 - 1991
• Main Authors: Spanjaart, Anne Mea, Ljungman, Per, Tridello, Gloria, Schwartz, Juana, Martinez-Cibrián, Nuria, Barba, Pere, Kwon, Mi, Lopez-Corral, Lucia, Martinez-Lopez, Joaquin, Ferra, Christelle, Di Blasi, Roberta, Ghesquieres, Hervé, Mutsaers, Pim, Calkoen, Friso, Jak, Margot, van Doesum, Jaap, Vermaat, Joost S P, 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 José, Mielke, Stephan
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 01.09.2024; Nature Publishing Group UK
• Subjects: Bone marrow transplantation; Cell therapy; Chimeric antigen receptors; COVID-19; Hematology; Infectious diseases; Lymphocytes B; Lymphocytes T; Lymphoma; Malignancy; Medicin och hälsovetenskap; Mortality; Multivariate analysis
• ISSN: 0887-6924; 1476-5551; 1476-5551
• DOI: 10.1038/s41375-024-02336-1

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.