Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
Institute of Translational Research, Cologne Excellence Cluster On Cellular Stress Responses in Aging-Associated Diseases (CECAD), University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany.
J Hematol Oncol. 2023 Apr 1;16(1):32. doi: 10.1186/s13045-023-01423-7.
Only few studies have analyzed the efficacy of tixagevimab/cilgavimab to prevent severe Coronavirus disease 2019 (COVID-19) and related complications in hematologic malignancies (HM) patients. Here, we report cases of breakthrough COVID-19 after prophylactic tixagevimab/cilgavimab from the EPICOVIDEHA registry). We identified 47 patients that had received prophylaxis with tixagevimab/cilgavimab in the EPICOVIDEHA registry. Lymphoproliferative disorders (44/47, 93.6%) were the main underlying HM. SARS-CoV-2 strains were genotyped in 7 (14.9%) cases only, and all belonged to the omicron variant. Forty (85.1%) patients had received vaccinations prior to tixagevimab/cilgavimab, the majority of them with at least two doses. Eleven (23.4%) patients had a mild SARS-CoV-2 infection, 21 (44.7%) a moderate infection, while 8 (17.0%) had severe infection and 2 (4.3%) critical. Thirty-six (76.6%) patients were treated, either with monoclonal antibodies, antivirals, corticosteroids, or with combination schemes. Overall, 10 (21.3%) were admitted to a hospital. Among these, two (4.3%) were transferred to intensive care unit and one (2.1%) of them died. Our data seem to show that the use of tixagevimab/cilgavimab may lead to a COVID-19 severity reduction in HM patients; however, further studies should incorporate further HM patients to confirm the best drug administration strategies in immunocompromised patients.
仅有少数研究分析了替沙吉韦单抗/西加韦单抗预防血液恶性肿瘤（HM）患者严重 2019 冠状病毒病（COVID-19）和相关并发症的疗效。在此，我们报告了 EPICOVIDEHA 登记处中接受替沙吉韦单抗/西加韦单抗预防后突破性 COVID-19 的病例。我们在 EPICOVIDEHA 登记处中确定了 47 例接受替沙吉韦单抗/西加韦单抗预防的患者。淋巴增生性疾病（44/47，93.6%）是主要的 HM 基础疾病。仅对 7 例（14.9%）进行了 SARS-CoV-2 株的基因分型，所有均属于奥密克戎变体。40 例（85.1%）患者在接受替沙吉韦单抗/西加韦单抗之前接受了疫苗接种，其中大多数人接种了至少两剂。11 例（23.4%）患者发生轻度 SARS-CoV-2 感染，21 例（44.7%）中度感染，8 例（17.0%）严重感染，2 例（4.3%）危重症感染。36 例（76.6%）患者接受了治疗，使用了单克隆抗体、抗病毒药物、皮质类固醇或联合方案。总体而言，10 例（21.3%）患者住院。其中，2 例（4.3%）转入重症监护病房，其中 1 例（2.1%）死亡。我们的数据似乎表明，替沙吉韦单抗/西加韦单抗的使用可能会降低 HM 患者 COVID-19 的严重程度；然而，还需要进一步的研究纳入更多的 HM 患者，以确认免疫功能低下患者的最佳药物管理策略。
