Serna Ángel, Navarro Víctor, Jiménez Moraima, Iraola-Truchuelo Josu, Bosch Marc, García Cristina, Falcó Anna, Albasanz Adaia, Ruiz-Camps Isabel, Andrés Cristina, Antón Andrés, Esperalba Juliana, Ferrero Ainara, García Tomás, Carpio Cecilia, Crespo Marta, Iacoboni Gloria, Marín-Niebla Ana, Bosch Francesc, Abrisqueta Pau
Servei d'Hematologia, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.
Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.
Blood Adv. 2025 Aug 26;9(16):4180-4189. doi: 10.1182/bloodadvances.2024015406.
Despite advances in vaccination and the use of antiviral treatments, patients with hematologic malignancies, including B-cell lymphoproliferative disorders, are particularly vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The recent introduction of bispecific antibodies (BsAbs) in the treatment algorithm of relapsed/refractory B-cell non-Hodgkin lymphoma (B-NHL) has raised concerns regarding their impact on COVID-19 outcomes. This study aimed to evaluate the impact of SARS-CoV-2 infection on treatment outcomes in patients receiving BsAbs. We assessed the severity of COVID-19 and SARS-CoV-2 serostatus, with antibody titers measured before, during, and after BsAbs administration. A total of 109 patients with B-NHL treated with BsAbs from March 2020 to January 2023 were included. SARS-CoV-2 infection was observed in 56 patients (51%), with 36% experiencing prolonged viral shedding, causing therapy delays in 78% of patients and permanent discontinuations in 19%. Regarding COVID-19 severity, 36% of patients presented moderate, 20% severe, and 12% critical disease. Seven patients (13%) died owing to COVID-19 pneumonia. Similar to observations with anti-CD20 monoclonal antibodies, BsAbs were associated with negative antispike serostatus for at least 6 months after treatment completion. Importantly, this lack of seroconversion was linked with severe disease and increased mortality. These findings underscore important considerations for the management of patients receiving BsAbs.
尽管在疫苗接种和抗病毒治疗的使用方面取得了进展，但包括B细胞淋巴增殖性疾病在内的血液系统恶性肿瘤患者，特别容易受到严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染。双特异性抗体（BsAbs）最近被引入复发/难治性B细胞非霍奇金淋巴瘤（B-NHL）的治疗方案中，这引发了人们对其对COVID-19结局影响的担忧。本研究旨在评估SARS-CoV-2感染对接受BsAbs治疗的患者治疗结局的影响。我们评估了COVID-19的严重程度和SARS-CoV-2血清状态，并在BsAbs给药前、给药期间和给药后测量了抗体滴度。纳入了2020年3月至2023年1月期间接受BsAbs治疗的109例B-NHL患者。56例患者（51%）观察到SARS-CoV-2感染，其中36%出现病毒持续脱落，导致78%的患者治疗延迟，19%的患者永久停药。关于COVID-19的严重程度，36%的患者为中度，20%为重度，12%为危重症。7例患者（13%）死于COVID-19肺炎。与抗CD20单克隆抗体的观察结果相似，BsAbs与治疗完成后至少6个月的抗刺突血清状态阴性有关。重要的是，这种血清转化缺乏与严重疾病和死亡率增加有关。这些发现强调了在管理接受BsAbs治疗的患者时需要重要考虑的因素。
