ArticleAnnals of hematology2025
SARS-CoV-2 infection does not affect the outcome of patients with relapsed/refractory large B-cell lymphoma treated with CAR T-cell therapy.
Article in Annals of hematology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Although the COVID-19 pandemic has officially ended, outbreaks still occur, especially in immunocompromised patients, including those undergoing chimeric antigen receptor T-cell (CAR T-cell) therapy, who have weakened immune systems due to prior treatments or CAR T-related effects such as severe and prolonged neutropenia, lymphopenia and hypogammaglobulinemia. This retrospective study analyzed relapsed/refractory (R/R) large B-cell lymphoma (LBCL) patients receiving CAR T-cell therapy, assessing the impact of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection on overall survival (OS), progression-free survival (PFS), and delays in leukapheresis and CAR T-cell infusion. Among 89 infused patients, 37 (41.6%) developed COVID-19. Compared to the COVID + cohort, COVID- patients had worse prognostic scores and higher LDH and ferritin levels before infusion. SARS-CoV-2 infection delayed leukapheresis (14-35 days) and CAR T-cell infusion (20-65 days). The best overall response rate (BRR) in the CAR T-cell population was 77.5% (69/89 patients), with a complete response (CR) rate of 67%. The BRR was 100% in COVID + patients vs. 61.5% in COVID-. Median PFS was 5.47 months in the COVID- cohort and not reached in the COVID + cohort (p = 0.007). Median OS was 19 months in COVID- patients and not reached in COVID+ (p < 0.0001). No significant survival differences were found between COVID + and COVID - patients. Improved outcomes likely resulted from widespread vaccination, prophylaxis, early antiviral treatments, and the emergence of less virulent SARS-CoV-2 variants, reducing disease severity and mortality, allowing for better management of these patients.
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