Cancer Res Treat.  2024 Jan;56(1):324-333. 10.4143/crt.2023.738.

Impact of T-Cell Engagers on COVID-19–Related Mortality in B-Cell Lymphoma Patients Receiving B-Cell Depleting Therapy

• Lee CM
• Choe PG
• Kang CK
• Jo HJ
• Kim NJ
• Yoon SS
• Kim TM
• Park WB
• Oh Md

• KMID: 2550347
• DOI: http://doi.org/10.4143/crt.2023.738

Abstract

Purpose
B-cell depleting therapies, including T-cell engager (TCE), are increasingly used for patients with hematologic malignancies, including during the coronavirus disease 2019 (COVID-19) pandemic. We aimed to evaluate the relationship between TCE therapy and COVID-19–related outcomes among patients with COVID-19 and B-cell lymphomas receiving B-cell depleting therapy.
Materials and Methods
This retrospective cohort study included patients with B-cell lymphoma, who were admitted to Seoul Natio-nal University Hospital with COVID-19 between September 2021 and February 2023, and received B-cell depleting therapy before COVID-19 diagnosis. Multivariable logistic regression was used to identify factors associated with severe to critical COVID-19 and COVID-19–related mortality.
Results
Of 54 patients with B-cell lymphomas and COVID-19 who received B-cell depleting therapy, 14 were treated with TCE (TCE group) and 40 with rituximab (RTX group). COVID-19–related mortality was higher in the TCE group than in the RTX group (57.1% vs. 12.5%, p=0.002). In multivariable analyses, TCE therapy (adjusted odds ratio [aOR], 7.08; 95% confidence interval [CI], 1.29 to 38.76; p=0.024) and older age (aOR, 1.06; 95% CI, 1.00 to 1.13; p=0.035) were associated with severe to critical COVID-19. TCE therapy (aOR, 8.98; 95% CI, 1.48 to 54.40; p=0.017), older age (aOR, 1.13; 95% CI, 1.02 to 1.26; p=0.022), and prior bendamustine therapy (aOR, 7.78; 95% CI, 1.17 to 51.65; p=0.034) were independent risk factors for COVID-19–related mortality.
Conclusion
B-cell lymphoma patients treated with TCE had significantly worse outcomes from COVID-19 than those treated with RTX. TCE therapy should be used with caution in B-cell lymphoma patients during the COVID-19 epidemic.

Keyword

COVID-19; T-cell engager; Rituximab; Mortality; B-cell depleting therapy

Figure

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  Fig. 1 Monthly numbers of study participants receiving coronavirus disease 2019 (COVID-19) diagnosis and confirmed COVID-19 cases in Korea. RTX, rituximab; TCE, T-cell engager.

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  Fig. 2 Clinical courses of patients with coronavirus disease 2019 (COVID-19) according to time from B-cell depleting therapy to COVID-19 diagnosis in the T-cell engager (TCE) and rituximab (RTX) groups.

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  Fig. 3 Comparison of coronavirus disease 2019 (COVID-19)–related survival between the T-cell engager (TCE) and rituximab (RTX) groups.

Reference

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