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Patients who receive chimeric antigen receptor (CAR) T-cell therapy or allogeneic stem cell transplants (allo-SCT) often exhibit some form of immunosuppression as a result of their treatment or transplant. In the era of COVID-19, severe disease has emerged as a grave concern in high-risk CAR T-cell therapy and allo-SCT patients who may have weakened immune systems. Monoclonal antibody (MoAb) treatments have been developed to help treat mild or moderate COVID-19, but little research has been carried out on the effects of these treatments in these types of patients.

This retrospective cohort study, published in the Journal of Clinical Oncology for the 2022 ASCO Annual Meeting, found promising results for the use of MoAbs in high-risk patients. A total of 33 adult patients with mild or moderate COVID-19 who received anti-spike SARS-CoV-2 MoAbs between December 2020 and November 2021 were included in the study. The MoAbs given included casirivimab/imdevimab (REGEN-COV), bamlanivimab, and sotrovimab.

Ultimately, the 6-month event-free and overall survivals for the allo-SCT patients were found to be 81% and 91%, respectively. Events were considered those that included disease progression, hospitalization due to COVID-19, or death from any cause. Three CAR T-cell patients were vaccinated before becoming infected with COVID-19. Only one  CAR T-cell patient was hospitalized due to severe COVID-19, which resulted in death.

In conclusion, this study provides valuable insight for infectious disease specialists who may be evaluating their efforts in treating high-risk patients with COVID-19. As more patients are using CAR T-cell therapy, it is important to be aware of the potential obstacles and solutions that may develop due to immunosuppression [1].

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 [1] Mohty, R., Thoendel, M., Swei, S., Bansal, R., Palmer, J., Hogan, W. J., Vergidis, P., Munoz, J., Iqbal, M., Yassine, F., Bennani, N. N., Hathcock, M., Murthy, H. S., Castro, J. E., Lin, Y., Razonable, R. R., & Kharfan-Dabaja, M. (2022, May). Treatment with anti-spike monoclonal antibodies in allogeneic HCT and CAR T-cell recipients with mild to moderate COVID: the Mayo Clinic experience. 2022 ASCO Annual Meeting, Chicago, IL. https://meetings.asco.org/abstracts-presentations/209039

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