随着时间的推移，接受 CAR T 细胞疗法治疗的患者的 COVID-19 结局有所改善：代表欧洲血液和骨髓移植协会 (EBMT) 传染病工作组 (IDWP) 和欧洲血液学协会 (EHA) 淋巴瘤组。
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.
发表日期：2024 Jul 23
作者：
Anne Mea Spanjaart, Per Ljungman, Gloria Tridello, Juana Schwartz, Nuria Martinez-Cibrián, Pere Barba, Mi Kwon, Lucia Lopez-Corral, Joaquin Martinez-Lopez, Christelle Ferra, Roberta Di Blasi, Hervé Ghesquieres, Pim Mutsaers, Friso Calkoen, Margot Jak, Jaap van Doesum, Joost S P Vermaat, Marjolein van der Poel, Johan Maertens, Massimiliano Gambella, Elisabetta Metafuni, Fabio Ciceri, Riccardo Saccardi, Emma Nicholson, Eleni Tholouli, Collin Matthew, Victoria Potter, Adrian Bloor, Caroline Besley, Claire Roddie, Keith Wilson, Arnon Nagler, Antonio Campos, Soeren Lykke Petersen, Frantisek Folber, Peter Bader, Jurgen Finke, Nicolaus Kroger, Nina Knelange, Rafael de La Camara, Marie José Kersten, Stephan Mielke
来源：
LEUKEMIA
摘要：
COVID-19 与接受嵌合抗原受体 (CAR) T 细胞疗法治疗血液恶性肿瘤的患者的高死亡率有关。在这里，我们调查了结果是否随着时间的推移而有所改善，主要目标是与前几年相比评估 2022 年 Omicron 期间的 COVID-19 死亡率。这项多中心研究的数据是使用 EBMT 开发的 MED-A 和 COVID-19 报告表收集的。分析纳入了 180 名患者，其中 2020 年诊断出 39 例，2021 年诊断出 35 例，2022 年诊断出 106 例。中位年龄为 58.9 岁（最小-最大：5.2-78.4）。随着时间的推移，与 COVID-19 相关的死亡率连续下降（2020 年：43.6%、2021 年：22.9%、2022 年：7.5%），并且在多变量分析中，感染年份是最强的生存预测因子（p = 0.0001）。与 2022 年与 2020-2021 年相比，出现下呼吸道症状（21.7% vs 37.8%，p = 0.01）、需要氧气支持（25.5% vs 43.2%，p = 0.01）或入住 ICU（5.7% vs 33.8%，p = 0.0001）。尽管随着时间的推移，与 COVID-19 相关的死亡率有所下降，但 CAR T 细胞接受者发生并发症的风险仍然高于普通人群。因此，我们持续建议对接受 B 细胞靶向 CAR T 细胞治疗的患者进行警惕的 COVID-19 监测，以确保在需要时实现最佳的感染预防和先进的治疗。© 2024。作者。
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.© 2024. The Author(s).