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Patients with Hematological Malignancies Treated with T-Cell or B-Cell Immunotherapy Remain at High Risk of Severe Forms of COVID-19 in the Omicron Era.
Zerbit, Jeremie; Detroit, Marion; Meyer, Antoine; Decroocq, Justine; Deau-Fischer, Benedicte; Deschamps, Paul; Birsen, Rudy; Mondesir, Johanna; Franchi, Patricia; Miekoutima, Elsa; Guerin, Corinne; Batista, Rui; Bouscary, Didier; Willems, Lise; Vignon, Marguerite.
  • Zerbit J; Department of Pharmacy, Hospital at Home, University Hospitals of Paris, 75014 Paris, France.
  • Detroit M; Clinical Pharmacy, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France.
  • Meyer A; Clinical Hematology, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France.
  • Decroocq J; Clinical Hematology, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France.
  • Deau-Fischer B; Institut Cochin, CNRS UMR8104, INSERM U1016, Université de Paris, 75019 Paris, France.
  • Deschamps P; Équipe Labellisée Ligue Nationale Contre le Cancer (LNCC), 75014 Paris, France.
  • Birsen R; Clinical Hematology, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France.
  • Mondesir J; Clinical Hematology, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France.
  • Franchi P; Institut Cochin, CNRS UMR8104, INSERM U1016, Université de Paris, 75019 Paris, France.
  • Miekoutima E; Équipe Labellisée Ligue Nationale Contre le Cancer (LNCC), 75014 Paris, France.
  • Guerin C; Clinical Hematology, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France.
  • Batista R; Institut Cochin, CNRS UMR8104, INSERM U1016, Université de Paris, 75019 Paris, France.
  • Bouscary D; Équipe Labellisée Ligue Nationale Contre le Cancer (LNCC), 75014 Paris, France.
  • Willems L; Clinical Hematology, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France.
  • Vignon M; Institut Cochin, CNRS UMR8104, INSERM U1016, Université de Paris, 75019 Paris, France.
Viruses ; 14(11)2022 Oct 27.
Article in English | MEDLINE | ID: covidwho-2090363
ABSTRACT

BACKGROUND:

Patients with hematological malignancies are at greater risk of severe COVID-19 and have been prioritized for COVID-19 vaccination. A significant proportion of them have an impaired vaccine response, both due to the underlying disease and to the treatments.

METHODS:

We conducted a prospective observational study to identify the specific risks of the outpatient population with hematological diseases.

RESULT:

Between 22 December 2021 to 12 February 2022, we followed 338 patients of which 16.9% (n = 57) developed SARS-CoV-2 infection despite previous vaccination (94.7%). COVID-19 patients were more likely to have received immunotherapy (85.5% vs. 41%, p < 10-4), and particularly anti-CD20 monoclonal antibodies (40% vs. 14.9%, p < 10-4) and Bruton's tyrosine kinase inhibitors (BTKi) (7.3% vs. 0.7%, p < 10-2). There was no significant difference in demographic characteristics or hematological malignancies between COVID-19-positive and non-positive patients. Patients hospitalized for COVID-19 had more frequently received immunotherapy than patients with asymptomatic or benign forms (100% vs. 77.3%, p < 0.05). Hospitalized COVID-19 patients had a higher proportion of negative or weakly positive serologies than non-hospitalized patients (92.3% vs. 61%, p < 0.05). Patients who received tixagevimab/cilgavimab prophylaxis (n = 102) were less likely to be COVID-19-positive (4.9 vs. 22%, p < 0.05) without significant difference in hospitalization rates.

CONCLUSION:

In the immunocompromised population of patients with hematological malignancies, the underlying treatment of blood cancer by immunotherapy appears to be a risk factor for SARS-CoV-2 infection and for developing a severe form.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hematologic Neoplasms / COVID-19 Type of study: Observational study / Prognostic study Topics: Vaccines / Variants Limits: Humans Language: English Year: 2022 Document Type: Article Affiliation country: V14112377

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hematologic Neoplasms / COVID-19 Type of study: Observational study / Prognostic study Topics: Vaccines / Variants Limits: Humans Language: English Year: 2022 Document Type: Article Affiliation country: V14112377