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

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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 | 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

Edité par CCSD ; Springer Nature -

International audience. 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.

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