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血液系统疾病患者合并 SARS-CoV-2 感染的综合治疗,包括抗 SARS-CoV-2 单克隆抗体:一项单中心经验病例系列研究。

Comprehensive Treatment of Hematological Patients with SARS-CoV-2 Infection Including Anti-SARS-CoV-2 Monoclonal Antibodies: A Single-Center Experience Case Series.

机构信息

Department of Medicine B for Gastroenterology, Hepatology, Endocrinology and Clinical Infectiology, University Hospital Muenster, 48149 Muenster, Germany.

Department of Medicine D for Nephrology and Rheumatology, University Hospital Muenster, 48149 Muenster, Germany.

出版信息

Curr Oncol. 2022 Mar 26;29(4):2312-2325. doi: 10.3390/curroncol29040188.

DOI:10.3390/curroncol29040188
PMID:35448162
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9032833/
Abstract

Patients with hematologic malignancies are at high risk of exacerbated condition and higher mortality from coronavirus disease 2019 (COVID-19). Bamlanivimab, casirivimab/imdevimab combination, and sotrovimab are monoclonal antibodies (mABs) that can reduce the risk of COVID-19-related hospitalization. Clinical effectiveness of bamlanivimab and casirivimab/imdevimab combination has been shown for the Delta variant (B.1.617.2), but the effectiveness of the latter treatment against the Omicron variant (B.1.1.529) has been suggested to be reduced. However, the tolerability and clinical usage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific mABs in patients with hematologic malignancies are less specified. We present a retrospective case series analysis of all SARS-CoV-2-infected patients with hematologic malignancies who received SARS-CoV-2-specific mABs at our facility between February and mid-December 2021. A total of 13 COVID-19 patients (pts) with at least one malignant hematologic diagnosis received SARS-CoV-2-specific mABs at our facility, with 3 pts receiving bamlanivimab and 10 pts receiving casirivimab/imdevimab combination. We observed SARS-CoV-2 clearance in five cases. Furthermore, we observed a reduction in the necessity for oxygen supplementation in five cases where the application was administered off-label. To the best of our knowledge, we present the largest collection of anecdotal cases of SARS-CoV-2-specific monoclonal antibody use in patients with hematological malignancies. Potential benefit of mABs may be reduced duration and/or clearance of persistent SARS-CoV-2 infection.

摘要

患有血液恶性肿瘤的患者感染 2019 冠状病毒病(COVID-19)的病情恶化和死亡率较高。巴姆洛单抗、卡瑞利珠单抗/西妥昔单抗组合和索托维单抗是可降低 COVID-19 相关住院风险的单克隆抗体(mABs)。巴姆洛单抗和卡瑞利珠单抗/西妥昔单抗组合对 Delta 变体(B.1.617.2)的临床疗效已得到证实,但后者对奥密克戎变体(B.1.1.529)的疗效降低。然而,在血液恶性肿瘤患者中,严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)特异性 mAB 的耐受性和临床应用尚未得到明确。我们回顾性分析了 2021 年 2 月至 12 月中旬期间在我们机构接受 SARS-CoV-2 特异性 mAB 治疗的所有患有血液恶性肿瘤的 SARS-CoV-2 感染患者。共有 13 例至少有一种恶性血液病诊断的 COVID-19 患者(pts)在我们机构接受了 SARS-CoV-2 特异性 mAB 治疗,其中 3 例接受了巴姆洛单抗,10 例接受了卡瑞利珠单抗/西妥昔单抗组合。我们观察到 5 例患者的 SARS-CoV-2 清除。此外,我们观察到在 5 例未标注适应证的患者中,需要氧疗的病例减少。据我们所知,我们提供了血液恶性肿瘤患者使用 SARS-CoV-2 特异性单克隆抗体的最大的偶然病例集合。mAB 的潜在益处可能是缩短持续 SARS-CoV-2 感染的持续时间和/或清除率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c70/9032833/621938675b49/curroncol-29-00188-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c70/9032833/7690a87a4cce/curroncol-29-00188-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c70/9032833/1280a64d230e/curroncol-29-00188-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c70/9032833/9c229e60208c/curroncol-29-00188-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c70/9032833/621938675b49/curroncol-29-00188-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c70/9032833/7690a87a4cce/curroncol-29-00188-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c70/9032833/1280a64d230e/curroncol-29-00188-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c70/9032833/9c229e60208c/curroncol-29-00188-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c70/9032833/621938675b49/curroncol-29-00188-g004.jpg

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