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Shah, Gunjan L; DeWolf, Susan; Lee, Yeon Joo; Tamari, Roni; Dahi, Parastoo B; Lavery, Jessica A; Ruiz, Josel; Devlin, Sean M; Cho, Christina; Peled, Jonathan U; Politikos, Ioannis; Scordo, Michael; Babady, N Esther; Jain, Tania; Vardhana, Santosha; Daniyan, Anthony; Sauter, Craig S; Barker, Juliet N; Giralt, Sergio A; Goss, Cheryl; Maslak, Peter; Hohl, Tobias M; Kamboj, Mini; Ramanathan, Lakshmi; van den Brink, Marcel Rm; Papadopoulos, Esperanza; Papanicolaou, Genovefa; Perales, Miguel-Angel
The Journal of clinical investigation, 12/2020, Letnik: 130, Številka: 12Journal Article
BACKGROUNDUnderstanding outcomes and immunologic characteristics of cellular therapy recipients with SARS-CoV-2 is critical to performing these potentially life-saving therapies in the COVID-19 era. In this study of recipients of allogeneic (Allo) and autologous (Auto) hematopoietic cell transplant and CD19-directed chimeric antigen receptor T cell (CAR T) therapy at Memorial Sloan Kettering Cancer Center, we aimed to identify clinical variables associated with COVID-19 severity and assess lymphocyte populations.METHODSWe retrospectively investigated patients diagnosed between March 15, 2020, and May 7, 2020. In a subset of patients, lymphocyte immunophenotyping, quantitative real-time PCR from nasopharyngeal swabs, and SARS-CoV-2 antibody status were available.RESULTSWe identified 77 patients with SARS-CoV-2 who were recipients of cellular therapy (Allo, 35; Auto, 37; CAR T, 5; median time from cellular therapy, 782 days; IQR, 354-1611 days). Overall survival at 30 days was 78%. Clinical variables significantly associated with the composite endpoint of nonrebreather or higher oxygen requirement and death (n events = 25 of 77) included number of comorbidities (HR 5.41, P = 0.004), infiltrates (HR 3.08, P = 0.032), and neutropenia (HR 1.15, P = 0.04). Worsening graft-versus-host disease was not identified among Allo recipients. Immune profiling revealed reductions and rapid recovery in lymphocyte populations across lymphocyte subsets. Antibody responses were seen in a subset of patients.CONCLUSIONIn this series of Allo, Auto, and CAR T recipients, we report overall favorable clinical outcomes for patients with COVID-19 without active malignancy and provide preliminary insights into the lymphocyte populations that are key for the antiviral response and immune reconstitution.FUNDINGNIH grant P01 CA23766 and NIH/National Cancer Institute grant P30 CA008748.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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in: SICRIS
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