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血液系统疾病轻中度 COVID-19 患者使用单克隆抗体治疗的回顾性单中心经验

Use of monoclonal antibody therapy in hematologic patients with mild-to-moderate COVID-19: A retrospective single-center experience.

机构信息

Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California, USA.

Department of Pharmacy, City of Hope National Medical Center, Duarte, California, USA.

出版信息

Cancer Med. 2023 May;12(10):11248-11253. doi: 10.1002/cam4.5832. Epub 2023 Apr 20.

Abstract

INTRODUCTION

In November 2020, the FDA issued an emergency use authorization (EUA) for monoclonal antibody (mAb) therapy in patients with mild-to-moderate COVID-19 at high risk for disease progression.

METHODS

We retrospectively reviewed 38 adult hematology patients who received mAbs from 11/2020 to 2/2021.

RESULTS

Thirty (79%) patients received bamlanivimab and 8 (21%) casirivimab-imdevimab. Four (11%) patients were hospitalized due to COVID-19, two (5%) progressed to severe disease and one patient (3%) died within 30 days from COVID-19 disease. Most patients (n = 34, 89%) ultimately tested negative for SARS-CoV-2, with 34% (n = 13) clearing the virus within 14 days after mAb infusion. The median time to clearance of viral shedding was 25.5 days (range: 7-138). After mAb infusion, most patients with hematological malignancies (HM) (n = 10/15; 67%) resumed therapy for underlying disease with a median delay of 21.5 days (range: 12-42). We observed a significant difference in hospitalization among patients who received a HCT versus non-HCT (0% n = 0/26 and 36% n = 4/11, respectively; p < 0.01).

CONCLUSIONS

This study demonstrates that SARS-CoV-2 specific mAb was safe and may reduce hospitalization compared to what is reported in malignant hematology patients at high risk for disease progression. Our HCT cohort patients had less hospitalization rate compared with HM cohort patients.

摘要

简介

2020 年 11 月,FDA 发布了针对有疾病进展高风险的轻度至中度 COVID-19 患者的单克隆抗体(mAb)治疗的紧急使用授权(EUA)。

方法

我们回顾性分析了 2020 年 11 月至 2021 年 2 月期间接受 mAb 的 38 例成年血液科患者。

结果

30 例(79%)患者接受了 bamlanivimab,8 例(21%)接受了 casirivimab-imdevimab。4 例(11%)患者因 COVID-19 住院,2 例(5%)进展为重症,1 例(3%)患者在 COVID-19 发病后 30 天内死亡。大多数患者(n=34,89%)最终 SARS-CoV-2 检测呈阴性,34%(n=13)在 mAb 输注后 14 天内清除病毒。病毒脱落清除的中位时间为 25.5 天(范围:7-138)。mAb 输注后,大多数血液恶性肿瘤(HM)患者(n=10/15;67%)恢复了基础疾病治疗,中位延迟时间为 21.5 天(范围:12-42)。我们观察到接受 HCT 与非 HCT 的患者之间的住院率有显著差异(0% n=0/26 和 36% n=4/11,分别;p<0.01)。

结论

这项研究表明,与疾病进展高风险的恶性血液病患者相比,SARS-CoV-2 特异性 mAb 是安全的,并且可能降低住院率。与 HM 患者队列相比,我们的 HCT 患者队列的住院率较低。

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