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Favorable outcomes of COVID-19 in recipients of hematopoietic cell transplantation

Favorable outcomes of COVID-19 in recipients of hematopoietic cell transplantation

Authors :
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 R.M.
Papadopoulos, Esperanza
Papanicolaou, Genovefa
Perales, Miguel-Angel
Source :
Journal of Clinical Investigation. December 2020, Vol. 130 Issue 12, p6656, 12 p.
Publication Year :
2020

Abstract

Introduction As of June 2, 2020, there were over 1.8 million confirmed cases of coronavirus disease 2019 (COVID-19), which is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), in [...]<br />BACKGROUND. Understanding 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. METHODS. We 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. RESULTS. We 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. CONCLUSION. In 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. FUNDING. NIH grant P01 CA23766 and NIH/National Cancer Institute grant P30 CA008748.

Details

Language :
English
ISSN :
00219738
Volume :
130
Issue :
12
Database :
Gale General OneFile
Journal :
Journal of Clinical Investigation
Publication Type :
Academic Journal
Accession number :
edsgcl.644418780
Full Text :
https://doi.org/10.1172/JCI141777