TY - JOUR
T1 - Favorable outcomes of COVID-19 in recipients of hematopoietic cell transplantation
AU - Shah, Gunjan L.
AU - DeWolf, Susan
AU - Lee, Yeon Joo
AU - Tamari, Roni
AU - Dahi, Parastoo B.
AU - Lavery, Jessica A.
AU - Ruiz, Josel
AU - Devlin, Sean M.
AU - Cho, Christina
AU - Peled, Jonathan U.
AU - Politikos, Ioannis
AU - Scordo, Michael
AU - Esther Babady, N.
AU - Jain, Tania
AU - Vardhana, Santosha
AU - Daniyan, Anthony
AU - Sauter, Craig S.
AU - Barker, Juliet N.
AU - Giralt, Sergio A.
AU - Goss, Cheryl
AU - Maslak, Peter
AU - Hohl, Tobias M.
AU - Kamboj, Mini
AU - Ramanathan, Lakshmi
AU - van den Brink, Marcel R.M.
AU - Papadopoulos, Esperanza
AU - Papanicolaou, Genovefa
AU - Perales, Miguel Angel
N1 - Funding Information:
We thank Jedd Wolchok for guidance and support for this project. This research was supported in part by NIH award P01 CA23766 and NIH/National Cancer Institute Cancer Center Support grant P30 CA008748. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The authors thank Theodore and Laura Hromadka for their support. SD was supported in part by Clinical Scholars 2T32 CA009512 through Memorial Sloan Kettering internal funding.
Publisher Copyright:
© 2020, American Society for Clinical Investigation.
PY - 2020/12/1
Y1 - 2020/12/1
N2 - 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.
AB - 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.
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U2 - 10.1172/JCI141777
DO - 10.1172/JCI141777
M3 - Article
C2 - 32897885
AN - SCOPUS:85096440606
VL - 130
SP - 6656
EP - 6667
JO - Journal of Clinical Investigation
JF - Journal of Clinical Investigation
SN - 0021-9738
IS - 12
ER -