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

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

Authors:	Shah, G. L.; DeWolf, S.; Lee, Y. J.; Tamari, R.; Dahi, P. B.; Lavery, J. A.; Ruiz, J.; Devlin, S. M.; Cho, C.; Peled, J. U.; Politikos, I.; Scordo, M.; Babady, N. E.; Jain, T.; Vardhana, S.; Daniyan, A.; Sauter, C. S.; Barker, J. N.; Giralt, S. A.; Goss, C.; Maslak, P.; Hohl, T. M.; Kamboj, M.; Ramanathan, L.; van den Brink, M. R. M.; Papadopoulos, E.; Papanicolaou, G.; Perales, M. A.
Article Title:	Favorable outcomes of COVID-19 in recipients of hematopoietic cell transplantation
Abstract:	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 (Alto) and autologous (Auto) hematopoietic cell transplant and CD19-directed chimeric antigen receptor T cell (CART) 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 degrees/0. 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 CART 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.
Keywords:	cord blood; therapy; reconstitution; trial; recovery; agent; npi-2358
Journal Title:	Journal of Clinical Investigation
Volume:	130
Issue:	12
ISSN:	0021-9738
Publisher:	American Society for Clinical Investigation
Date Published:	2020-12-01
Start Page:	6656
End Page:	6667
Language:	English
ACCESSION:	WOS:000600240600002
DOI:	10.1172/jci141777
PROVIDER:	wos
PMCID:	PMC7685738
PUBMED:	32897885
Notes:	Article -- Source: Wos