Poor outcome of patients with COVID-19 after CAR T-cell therapy for B-cell malignancies: results of a multicenter study on behalf of the European Society for Blood and Marrow Transplantation (EBMT) Infectious Diseases Working Party and the European Hematology Association (EHA) Lymphoma Group

Spanjaart, Anne M.; Ljungman, Per; Cámara, Rafael de la; Tridello, Gloria; Ortiz-Maldonado, Valentín; Urbano-Ispizúa, Álvaro; Barba, Pere; Kwon, Mi; Caballero, Dolores; Sesques, Pierre; Bachy, Emmanuel; Blasi, Roberta Di; Thiéblemont, Catherine; Calkoen, Friso; Mutsaers, Pim G.N.J.; Maertens, Johan; Giannoni, Livia; Nicholson, Emma; Collin, Matthew; Vaz, Carlos Pinho; Metafuni, Elisabetta; Martínez‐López, Joaquín; Dignan, Fiona L.; Ribera, Josep‐María; Nagler, Arnon; Folber, František; Sanderson, Robin; Bloor, Adrian; Ciceri, Fabio; Knelange, Nina; Ayuk, Francis A.; Kröger, Nicolaus; Kersten, Marie José; Mielke, Stephan

doi:10.1038/s41375-021-01466-0

Cited by 92 publications

(84 citation statements)

References 15 publications

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“…These findings provide insight into why severely lymphodepleted CAR T recipients, independent of their remission status, may have high mortality. Given that the COVID-19-attributable mortality rate in the European Bone Marrow Transplant (EBMT) registry study was 41% ( Spanjaart et al., 2021 ), and continued blunted humoral responses despite one and two additional vaccine doses demonstrated in a recent study ( Sesques et al., 2022 ), the results of our analysis, showing at least partial success in seroconversion with booster among CAR T recipients, are encouraging.…”

Section: Main Textsupporting

confidence: 51%

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Efficacy of a third SARS-CoV-2 mRNA vaccine dose among hematopoietic cell transplantation, CAR T cell, and BiTE recipients

et al. 2022

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Section: Main Textsupporting

confidence: 51%

“…Hematopoietic cell transplantation (HCT) and cellular therapy (CT) recipients have poor outcomes after developing COVID-19 ( Spanjaart et al., 2021 , Meir et al., 2021 ). HCT and/or CT recipients also have blunted responses to SARS-CoV-2 vaccines ( Dhakal et al., 2021 ).…”

Section: Main Textmentioning

confidence: 99%

Efficacy of a third SARS-CoV-2 mRNA vaccine dose among hematopoietic cell transplantation, CAR T cell, and BiTE recipients

et al. 2022

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“…However, the pandemic is relevant to mention as it pertains to the dynamics discussed above. Cancer patients, in particular patients receiving some types of immunotherapy such as CD19-directed chimeric antigen receptor T-cells [ 64 , 65 ], are highly vulnerable to SARS-CoV-2 infection and development of severe symptoms [ 66 ]. They have thus been socially distancing in extreme measure in recent years, making the social support structures in place for immunotherapy patients all the more important in light of the dynamics highlighted by the CLD.…”

Section: Discussionmentioning

confidence: 99%

Health-related quality of life in cancer immunotherapy: a systematic perspective, using causal loop diagrams

et al. 2022

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Purpose System science offers a unique set of tools, including causal loop diagrams (CLDs), for stakeholders to better grasp the complexity of factors surrounding quality of life. Because the health-related quality of life (HRQoL) of cancer immunotherapy patients exists within an intricate system affected by and affecting many factors across multiple dimensions, the development of a systems-level model can provide a powerful framework to aid the understanding of this complexity. We developed a CLD for HRQoL of cancer immunotherapy patients. Methods We first applied a literature-based approach to construct a CLD for patients following immunotherapy. We then iteratively reviewed and enhanced the CLD through interviews with subject matter experts. Results Based on the reviewed literature and subject matter expert input, we produced a CLD representing the system surrounding cancer immunotherapy patients’ HRQoL. Several feedback loops are identified that span clinical experiences, oncology teams’ perceptions about immunotherapy, social support structures, and further research and development in cancer immunotherapy, in addition to other components. The CLD enables visualization of thought experiments regarding how a change anywhere in the system can ultimately worsen or improve patients’ HRQoL. Conclusion The CLD illustrates the valuable contribution of a systems perspective to quality-of-life research. This systems-based qualitative representation gives insight on strategies to inhibit harmful effects, enhance beneficial effects, and inherent tradeoffs within the system. The CLD identifies gaps in the literature and offers a communication tool for diverse stakeholders. Our research method provides an example for studying the complexities of quality of life in other health domains.

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“…One patient included in our study was vaccinated 4 years after CAR-T cell therapy and demonstrated longstanding severe B-cell depletion with absent antibody production to the vaccine. Again, additional vaccines doses may not be an effective strategy to increase antibody levels in that population at risk of very poor outcomes if infected with SAR-CoV-2 [25] . Baseline B-cell cytopenia can also occur in lymphoma and CLL patients prior to initiating therapy and likely partially explains why untreated patients have been reported to have poor responses to COVID vaccines.…”

Section: Discussionmentioning

confidence: 99%

B-cell cytopenia and time to last B-cell-depleting therapy predict response to SARS-COV-2 vaccines in patients with lymphoproliferative disorders

Tanguay

Boutin

Laumaea

et al. 2022

Vaccine

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Patients with B-non-Hodgkin lymphoma (NHL) are at increased risk of morbidity and mortality from SARS-CoV-2. We investigated the relationship between B cell cytopenia and the SARS-CoV-2 vaccine response in B-NHL patients. We measured anti-RBD antibodies and the lymphocyte immunophenotype in 19 controls, 22 lymphoma patients on observation (cohort 1) and 55 lymphoma patients receiving their vaccines post B-cell depleting therapy (cohort 2). Half of the lymphoma patients in both cohorts achieved seropositivity compared to 100% of controls. In cohort 2, only 5% achieved an antibody response in the first year post B-cell depleting treatment, vs 88% treated >2 years prior. Also, 28% of patients with <50 B cells/µl achieved a serologic response vs 86% of patients with B-cell >50 B cells/µl. B-cell cytopenia is profound within the first year of exposure to B-cell depleting treatment, therefore an additional dose of vaccine within that timeframe is unlikely to raise antibody levels.

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Poor outcome of patients with COVID-19 after CAR T-cell therapy for B-cell malignancies: results of a multicenter study on behalf of the European Society for Blood and Marrow Transplantation (EBMT) Infectious Diseases Working Party and the European Hematology Association (EHA) Lymphoma Group

Cited by 92 publications

References 15 publications

Efficacy of a third SARS-CoV-2 mRNA vaccine dose among hematopoietic cell transplantation, CAR T cell, and BiTE recipients

Efficacy of a third SARS-CoV-2 mRNA vaccine dose among hematopoietic cell transplantation, CAR T cell, and BiTE recipients

Health-related quality of life in cancer immunotherapy: a systematic perspective, using causal loop diagrams

B-cell cytopenia and time to last B-cell-depleting therapy predict response to SARS-COV-2 vaccines in patients with lymphoproliferative disorders

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