Blood Advances, Год журнала: 2023, Номер 7(21), С. 6767 - 6770
Опубликована: Авг. 30, 2023
Язык: Английский
Experimental Hematology and Oncology, Год журнала: 2023, Номер 12(1)
Опубликована: Июль 27, 2023
Abstract The outbreak of coronavirus disease 2019 (COVID-19) posed an unprecedented challenge on public health systems. Despite the measures put in place to contain it, COVID-19 is likely continue experiencing sporadic outbreaks for some time, and individuals will remain susceptible recurrent infections. Chimeric antigen receptor (CAR)-T recipients are characterized by durable B-cell aplasia, hypogammaglobulinemia loss T-cell diversity, which lead increased proportion severe/critical cases a high mortality rate after infection. Thus, treatment decisions have become much more complex require greater caution when considering CAR immunotherapy. Hence, we reviewed current understanding reported clinical experience management CAR-T therapy. After panel discussion, proposed rational procedure pertaining with aim maximizing benefit therapy post pandemic era.
Язык: Английский
Процитировано
10
Clinical Hematology International, Год журнала: 2024, Номер 6(2)
Опубликована: Апрель 29, 2024
Chimeric antigen receptor T-cell (CAR T-cell) therapy has changed the paradigm of management non-Hodgkin's lymphoma (NHL) and Multiple Myeloma. Infection complications have emerged as a concern that can arise in setting lead to morbidity mortality. In this review, we classified infection into three categories, pre-infusion phase from time pre- lymphodepletion (LD) up day zero, early infusion 30 post-infusion, late after onwards. Infections arising are closely related previous chemotherapy bridging therapy. more likely LD chemo expected brief period grade 3-4 neutropenia. particularly worrisome because they associated with adverse risk features including prolonged neutropenia, dysregulation humoral adaptive immunity lymphopenia, hypogammaglobinemia, B cell aplasia. Bacterial, respiratory other viral infections, protozoal fungal infections occur during . We recommend enhanced supportive care prompt recognition treatment neutropenia growth factor support, surveillance testing for specific viruses appropriate instance, hypogammaglobulinemia repletion extended antimicrobial prophylaxis those at higher (e.g. high dose steroid use cytopenia). Finally, re-immunizing patients post CAR-T based on CDC transplant guidelines.
Язык: Английский
Процитировано
3
Leukemia Research, Год журнала: 2024, Номер 143, С. 107544 - 107544
Опубликована: Июнь 25, 2024
Язык: Английский
Процитировано
3
Cancer Science, Год журнала: 2023, Номер 115(1), С. 237 - 246
Опубликована: Окт. 26, 2023
Despite concerns about an increased risk of adverse outcomes following coronavirus disease (COVID-19) in multiple myeloma patients treated with anti-CD38 Abs, the impact COVID-19 on this group is unclear. We tried to evaluate clinical these patients. collected data from 1036 and enrolled 509 cases COVID-19. divided into daratumumab or nondaratumumab cohorts based whether they had received daratumumab-based treatment within 6 months infection. applied a propensity score matching method reduce bias baseline characteristics, then compared incidence between two cohorts. A total 117 were cohort, 392 cohort. After matching, 204 matched. The proportions who developed pneumonia (59.8% vs. 34.3%, p < 0.001), hospitalized (33.3% 11.8%, 0.001) severe (23.5% 6.9%, = higher matched By multivariate analysis, exposure was independent factor for disease. An ECOG performance status >2 history chronic kidney factors COVID-19-related mortality among therapy. This study suggested that exposed at
Язык: Английский
Процитировано
7
Transfusion, Год журнала: 2024, Номер 64(3), С. 443 - 448
Опубликована: Фев. 8, 2024
Abstract Background Patients with severe B‐cell depletion related to hematological malignancies or targeted therapy suffer from impaired antibody responses SARS‐CoV‐2 and are at risk for prolonged COVID‐19. In this population, COVID‐19 convalescent plasma (CCP) may provide passive immunity, enhance immune response, promote virus neutralization. This study evaluated outcomes of depleted patients persistent treated CCP. Study Design Methods analysis included all consecutive severely COVID‐19, receiving CCP Rambam between 01.2022–02.2023. Persistent was defined as the presence symptoms ≥14 days in negative nucleocapsid test results. Results Twenty met inclusion criteria, 17 whom had malignancies, two suffered rheumatoid arthritis one both. Twelve received anti‐CD‐20 treatment, ‐ CAR‐T cells three underwent stem cell transplantation. The median duration 27.5 (range 14–97); 12 mild‐to‐moderate 8 infection. Sixteen required hospitalization. majority other therapies before Within a 1–16) post‐infusion, 19/20 clinically improved. No CCP‐associated adverse events were documented. recurred 3 improved patients. Two died on 1 90 following first infusion. Discussion is safe associated rapid clinical improvement. subset immunocompromised could particularly benefit administration.
Язык: Английский
Процитировано
2
Life, Год журнала: 2024, Номер 14(3), С. 389 - 389
Опубликована: Март 15, 2024
Remarkable advancements have been made in the treatment outcomes of multiple myeloma (MM) patients; however, for frail elderly patients, these are still insufficient. Elderly MM patients increasing, as their regimens. There is a heightened demand to assess order provide optimized treatments. While continuous more common when compared fixed-duration treatment, due risk interruption causing reduced survival rates, effectiveness and safety essential. Treatment goals vary each patient, but must preserve quality life (QOL). When planning treatments frailty evaluation increasingly emphasized stratification factor which helps develop accurate screening tools. Daratumumab (DARA) therapy, used globally, not only effective also has QOL benefits. Proficiency utilizing DARA regimens potentially advantageous included clinical trials, innovative usage can further broaden its scope. The development tools accurately establishment optimal imperative. This review an overview, challenging assessments re-examining evidence discussing potential areas improvement.
Язык: Английский
Процитировано
2
Clinical Lymphoma Myeloma & Leukemia, Год журнала: 2024, Номер 24(9), С. 592 - 603
Опубликована: Май 4, 2024
Язык: Английский
Процитировано
2
Infectious Agents and Cancer, Год журнала: 2024, Номер 19(1)
Опубликована: Май 27, 2024
Abstract This paper introduces two cases of multiple myeloma, COVID-19 infection during autologous stem cell transplantation, the treatment process, and different results patients, which provides a reference for how to carry out ASCT safely normalization stage.
Язык: Английский
Процитировано
2
Frontiers in Medicine, Год журнала: 2023, Номер 10
Опубликована: Окт. 9, 2023
Background The effect of booster vaccinations with the coronavirus virus disease (COVID-19) vaccine on people living HIV (PLWH) remains unknown. In this study, we aimed to investigate immunogenicity and effectiveness doses COVID-19 in PLWH. Methods Literature research was done through PubMed, Embase, Cochrane Review, Web Science databases up 4 July 2023. Pooled estimates were calculated compared using DerSimonian Laird method for a random effects model. Randomized control trials observational studies both considered inclusion. Results We included 35 eligible covering 30,154 pooled immune response rate (IRR) PLWH after vaccination 97.25% (95% confidence interval [CI], 93.81–99.49), similar healthy (HC) (risk ratio [RR] = 0.98, 95% CI, 0.96–1.00). IRR CD4 + T-cell counts ≤ 200 86.27 65.35–99.07). For Omicron variants, dose 74.07% 58.83–89.30), risk reduced by 10% HC (RR 0.90, 0.80–1.00). found be comparable ( p ≥ 0.05). Subgroup analyses revealed that mRNA vaccines produced relatively high other vaccines. addition, results showed appeared further reduce COVID-19-related infections, hospitalizations, deaths primary vaccination. Conclusion It shown provided still desirable moderate count 200. Importantly, humoral responses HC, observed SARS-CoV-2 variant. Our review strongly emphasizes eliciting protective IRR. Furthermore, appears infection, hospitalization, death However, more evidence is needed confirm its effectiveness.
Язык: Английский
Процитировано
6
Diseases, Год журнала: 2023, Номер 11(3), С. 123 - 123
Опубликована: Сен. 18, 2023
Background: tixagevimab/cilgavimab, distributed under the name "Evusheld", was first available pre-exposure prophylaxis for COVID-19 other than vaccination. It received an EUA from FDA after sufficient trial data showed efficacy in preventing SARS-CoV-2 infections and subsequent severe disease. Its potential benefits high-risk immunocompromised patients generated a lot of interest. Individuals with multiple myeloma fall into this category, as they are characterized by attenuated immune responses and, some cases, vaccines have limited efficacy. Methods: single-center, prospective study included consecutive myeloma. All individuals were considered due to their underlying Baseline demographic clinical characteristics, well regarding infection antibodies, collected. Patients administered two intramuscular 150 mg doses Evusheld monitored during follow-up period. Results: one hundred eleven analysis, median age 64 years (range 58-69) fifty-three females (47.7%). Fourteen (12.6%) had prior history all vaccinated either three or four mRNA-based vaccines. An increase observed neutralizing-antibody levels before tixagevimab/cilgavimab administration, 92.6% 97.3%. The high sustainable, level 95.4% at 3 months post administration. Overall, nine (8.1%) diagnosed period, 31 days. There no SARS-CoV-2- infection-related hospitalizations deaths. monoclonal antibody combination tolerated, infusion-related reactions major adverse events, pain injection site only reported 33 (30%). Conclusions: (Evusheld) seemed beneficial myeloma, who presented low incidence initial Omicron wave. No new safety concerns emerged. However, novel combinations antibodies against circulating variants deemed necessary view emergence tolerance.
Язык: Английский
Процитировано
4