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Anti-BCMA CAR T administration in a relapsed and refractory multiple myeloma patient after COVID-19 infection: a case report.
Madduri, D; Parekh, S; Campbell, T B; Neumann, F; Petrocca, F; Jagannath, S.
  • Madduri D; Department of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Pl, Box 1185, New York, NY, 10029, USA. Deepu.Madduri@mountsinai.org.
  • Parekh S; Department of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Pl, Box 1185, New York, NY, 10029, USA.
  • Campbell TB; Bristol-Myers Squibb, Princeton, NJ, USA.
  • Neumann F; bluebird bio, Cambridge, MA, USA.
  • Petrocca F; bluebird bio, Cambridge, MA, USA.
  • Jagannath S; Department of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Pl, Box 1185, New York, NY, 10029, USA.
J Med Case Rep ; 15(1): 90, 2021 Feb 19.
Article in English | MEDLINE | ID: covidwho-1090621
ABSTRACT

BACKGROUND:

Very little is known about the risk that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral infection poses to cancer patients, many of whom are immune compromised causing them to be more susceptible to a host of infections. As a precautionary measure, many clinical studies halted enrollment during the initial surge of the global Novel Coronavirus Disease (COVID-19) pandemic. In this case report, we detail the successful treatment of a relapsed and refractory multiple myeloma (MM) patient treated with an anti-B cell maturation antigen (BCMA) chimeric antigen receptor (CAR) T cell therapy immediately following clinical recovery from COVID-19. CASE PRESENTATION The 57 year old Caucasian male patient had a 4-year history of MM and was considered penta-refractory upon presentation for CAR T cell therapy. He had a history of immunosuppression and received one dose of lymphodepleting chemotherapy (LDC) the day prior to COVID-19 diagnosis; this patient was able to mount a substantial immune response against the SARS-CoV-2 virus, and antiviral antibodies remain detectable 2 months after receiving anti-BCMA CAR T cell therapy. The recent SARS-CoV-2 infection in this patient did not exacerbate CAR T-associated cytokine release syndrome (CRS) and conversely the CAR T cell therapy did not result in COVID-19-related complications. One month after CAR T cell infusion, the patient was assessed to have an unconfirmed partial response per International Myeloma Working Group (IMWG) criteria.

CONCLUSION:

Our case adds important context around treatment choice for MM patients in the era of COVID-19 and whether CAR T therapy can be administered to patients who have recovered from COVID-19. As the COVID-19 global pandemic continues, the decision of whether to proceed with CAR T cell therapy will require extensive discussion weighing the potential risks and benefits of therapy. This case suggests that it is possible to successfully complete anti-BCMA CAR T cell therapy after recovery from COVID-19. CRB-402 study registered 6 September 2017 at clinicaltrials.gov (NCT03274219).
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Immunotherapy, Adoptive / B-Cell Maturation Antigen / Receptors, Chimeric Antigen / COVID-19 / Multiple Myeloma Type of study: Case report / Diagnostic study / Prognostic study Topics: Long Covid / Vaccines / Variants Limits: Humans / Male / Middle aged Language: English Journal: J Med Case Rep Year: 2021 Document Type: Article Affiliation country: S13256-020-02598-0

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Immunotherapy, Adoptive / B-Cell Maturation Antigen / Receptors, Chimeric Antigen / COVID-19 / Multiple Myeloma Type of study: Case report / Diagnostic study / Prognostic study Topics: Long Covid / Vaccines / Variants Limits: Humans / Male / Middle aged Language: English Journal: J Med Case Rep Year: 2021 Document Type: Article Affiliation country: S13256-020-02598-0