COVID-19 outcomes in CAR-T and HSCT recipients

Muhammad Bilal Abid, MD, MRCP, Medical College of Wisconsin, Milwaukee, WI, talks on the outcomes of chimeric antigen receptor T-cell (CAR-T) and hematopoietic stem cell transplant (HSCT) recipients who develop COVID-19. A recent study from the Center for International Blood and Marrow Transplant Research (CIBMTR) registry examining 318 HSCT recipients reported a mortality risk of 30% at 30 days after COVID-19 infection and demonstrated that lymphopenia at the time of COVID-19 diagnosis was correlated with higher mortality. In addition, among autologous HSCT (autoHSCT) recipients, it was found that patients with lymphoma had a higher mortality risk than patients with multiple myeloma. For allogeneic HSCT (alloHSCT) recipients, older age, male gender and development of COVID-19 within a year of transplantation were all factors associated with a higher mortality risk. Several studies have reported similar results indicating that older age, presence of active graft-versus-host disease (GvHD) and development of COVID-19 within a year of transplantation were associated with a higher mortality risk. There is less data investigating the COVID-19 outcomes of CAR-T recipients. A recent study examined the outcomes of five patients with B-cell non-Hodgkin lymphoma (NHL) receiving CD19 CAR-T therapy who developed COVID-19. In addition, post-mortem sequencing of an elderly patient with relapsed/refractory multiple myeloma receiving CAR-T therapy who died after COVID-19 infection revealed a significantly diminished humoral and cellular immune response. This interview was recorded virtually.