Having more than 2 comorbidities (= 0.002) and an active hematologic malignancy (= 0.02) predicted for increased disease severity by univariable analysis (Supplemental Table 3). Table 2 Univariable analysis of composite endpoint of requiring nonrebreather or more oxygen and death at lower level of oxygen Open in a separate window Evaluation of lymphocyte subsets in individuals positive for SARS-CoV-2 after bone marrow transplant Monitoring of immune reconstitution after transplant is standard clinical practice at MSKCC, including lymphocyte subsets (CD4+ T cells, CD8+ T cells, CD19+ B cells, CD56+CD16+ NK cells, and CD3+CD56+CD16+ NKT cells) and, in some individuals, additional T cell populations, including naive (CD45RA+CCR7+), central memory space (CD45RACCCR7+), effector memory space (CD45RACCCR7C), and effector memory space CD45RA+ or TEMRA cells (CD45RA+CCR7C) (14, 15). 3.08, = 0.032), and neutropenia (HR 1.15, = 0.04). Worsening graft-versus-host disease was not recognized among Allo recipients. Immune profiling exposed reductions and quick recovery in lymphocyte populations across lymphocyte subsets. Antibody reactions were seen in a subset of individuals. CONCLUSION With this series of Allo, Auto, and CAR T recipients, we statement overall favorable medical outcomes for individuals with COVID-19 without active malignancy and provide preliminary insights into the lymphocyte populations that are key for the antiviral response and immune reconstitution. FUNDING NIH give P01 CA23766 and NIH/National Malignancy Institute give P30 CA008748. = 35; Auto, = 37; CAR T, = ZXH-3-26 5) met criteria for analysis of COVID-19, with median follow-up in surviving individuals of 23 days (IQR, 14C35 days). The median age at COVID-19 analysis was 62 years (range, 25C78 years), with 17% over the age of 70 years and 64% ZXH-3-26 male sex (Table 1). Median time from most recent cell therapy was 782 days (IQR, 354C1611 days). All CAR T recipients received FDA-approved commercial products with 80% axicabtagene ciloleucel. At time of COVID-19 analysis, 17% of Allo recipients experienced active graft-versus-host disease (GVHD), which did not worsen during their program. No individuals experienced a new analysis of GVHD during their COVID-19 treatment. Table 1 Patient Mouse monoclonal to CD59(PE) characteristics Open in a separate window Most individuals experienced by no means smoked (66%) or vaped (96%). The median BMI was 27.4 kg/m2 (IQR, 24.1C30.6 kg/m2). At the time of COVID-19 analysis, 22% of individuals experienced 2 comorbidities when considering hypertension, congestive heart failure, chronic obstructive pulmonary disease, diabetes mellitus, HIV, and chronic kidney disease, while 44% experienced none of these issues (Number 1). Patients were on aspirin (26%); immunomodulatory providers (lenalidomide/pomalidomide, 23%); GVHD immunosuppressive providers (tacrolimus, cyclosporine, mycophenolate mofetil, and/or ruxolitinib, 18%); steroids (13%); angiotensin-converting-enzyme inhibitors/angiotensin receptor blockers (7%); and anticoagulation medications (5%). No individuals were on BTK inhibitors at the time of COVID-19 analysis. Thirteen percent of individuals received intravenous immunoglobulin within 3 months prior to COVID-19 analysis. Open in a separate window Number 1 Comorbidities at COVID-19 analysis.Seventy-seven individuals (Allo = 35, Auto = 37, CAR T = 5). COPD, chronic obstructive pulmonary disease; HTN, hypertension; CHF, congestive heart failure; DM, diabetes mellitus; CKD, chronic kidney disease. Concerning the status of the hematologic malignancy, 25% experienced relapse or progression of disease after ZXH-3-26 Allo, Auto, or CAR T. At the time of COVID-19 analysis, the most recent disease status was in remission not on treatment, in remission on consolidation or maintenance treatment, stable disease but not in remission, or relapsed/refractory disease in 48%, 22%, 14%, and 16% of individuals, respectively. As most individuals were in remission or on maintenance, 62% did not have any changes in treatment plan at time of analysis, but treatment was delayed or permanently discontinued in 31% and 3%, respectively. Symptoms and medical program Clinical demonstration. Seventy-four individuals experienced a positive nasopharyngeal swab (NPS) for SARS-CoV-2 RNA (25% tested outside MSKCC), with 3 individuals having presumed disease and 45% possessing a known positive contact. Symptoms at analysis included cough (65%), fever (58%), fatigue (39%), shortness of breath (30%), myalgias (27%), headache (16%), nausea/vomiting (10%), anosmia (9%), rhinorrhea (8%), misunderstandings (8%), diarrhea (7%), and diaphoresis (4%). At time of initial positive NPS, oxygen saturation was checked in 43 individuals (56%) and was below 90% in 21%. Fifty percent of individuals experienced imaging carried out, with 64% of those studies exposing an infiltrate. Laboratory data. Laboratory checks were performed in.
