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2. COVID-19 and CAR T cells: a report on current challenges and future directions from the EPICOVIDEHA survey by EHA-IDWP

Author

Johan Maertens, Austin Kulesekararaj, Carolina Garcia-Vidal, Nina Khanna, Ildefonso Espigado, Alessandro Busca, Martin Hoenigl, Philipp Koehler, Anna Guidetti, Nikolai Klimko, Ramón García-Sanz, Josip Batinić, Alba Cabirta, Antonio Pagliuca, Rémy Duléry, Francesca Farina, Oliver A. Cornely, Jon Salmanton-García, Sylvain Lamure, Anna Nordlander, Francesco Passamonti, Lubos Drgona, Francesco Marchesi, Barbora Weinbergerova, Alberto Lopez-Garcia, Iker Falces-Romero, Livio Pagano, Paolo Corradini, Roberta Di Blasi, Institut Català de la Salut, [Busca A] Stem Cell Transplant Center, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Turin, Italy. [Salmanton-García J] Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Faculty of Medicine and University Hospital Cologne, Cologne, Germany. Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University Hospital Cologne, Cologne, Germany. [Corradini P] University of Milan and Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy. [Marchesi F] Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy. [Cabirta A] Servei d’Hematologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. [Di Blasi R] Hôpital Saint Louis, Assistance Publique–Hopitaux de Paris (AP-HP), Paris, France, and Vall d'Hebron Barcelona Hospital Campus

Subjects
medicine.medical_specialty, CAR-T cells, Coronavirus disease 2019 (COVID-19), T-Lymphocytes, medicine.medical_treatment, Adoptive, Psychological intervention, MEDLINE, registry, Therapeutics::Biological Therapy::Immunomodulation::Immunotherapy::Immunization::Immunization, Passive::Adoptive Transfer::Immunotherapy, Adoptive [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], COVID-19 (Malaltia), Immunotherapy, Adoptive, terapéutica::terapia biológica::inmunomodulación::inmunoterapia::inmunización::inmunización pasiva::transferencia adoptiva::inmunoterapia adoptiva [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Receptors, Case fatality rate, virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES], Humans, Medicine, Cells::Blood Cells::Leukocytes::Leukocytes, Mononuclear::Lymphocytes::T-Lymphocytes [ANATOMY], 030304 developmental biology, 0303 health sciences, Receptors, Chimeric Antigen, Hematology, business.industry, Prevention, Teràpia cel·lular, Risk of infection, Chimeric Antigen, COVID-19, Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES], Immunosuppression, Stimulus Report, Chimeric antigen receptor, 3. Good health, Settore MED/15 - MALATTIE DEL SANGUE, Good Health and Well Being, Cèl·lules T, 030220 oncology & carcinogenesis, Immunotherapy, Infection, business, células::células sanguíneas::leucocitos::leucocitos mononucleares::linfocitos::linfocitos T [ANATOMÍA]
Abstract

Patients receiving chimeric antigen receptor T cells (CAR-T cells) therapy may be particularly susceptible to coronavirus disease 2019 (COVID-19) because of several factors including the immunosuppression associated to the underlying disease and delayed cytopenias. Regrettably, data on outcomes of CAR-T recipients with COVID-19 are extremely scarce. The aim of this study was to investigate the characteristics and outcomes of COVID-19 in patients treated with CAR-T therapy. The European Hematology Association - Scientific Working Group Infection in Hematology endorsed a survey to collect and analyze data from patients developing COVID-19 after CAR-T therapy. Overall, 459 patients treated with CAR-T cells were reported from 18 European centers. The prevalence of COVID-19 cases was 4.8%. Median time from CAR-T therapy and COVID-19 diagnosis was 169 days. Severe infection occurred in 66.7% of patients and 43.3% of the subjects required admission to ICU. The COVID-19 mortality was 33%. In multivariable analysis, the disease status at the time of COVID-19 trended marginally towards adverse outcome (P=0.075). In conclusion, we documented a high fatality rate for CAR-T patients with COVID-19, supporting the need to design successful interventions to mitigate the risk of infection in this vulnerable group of patients.

Published
2022
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