Clinical characteristics and outcomes of BCMA-targeted CAR-T cell recipients with COVID-19 during the Omicron wave: a retrospective study - Scorecard - MDSpire
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Clinical characteristics and outcomes of BCMA-targeted CAR-T cell recipients with COVID-19 during the Omicron wave: a retrospective study
Clinical Scorecard: Outcomes and Clinical Features of CAR-T Cell Patients Targeting BCMA with COVID-19 During the Omicron Surge: A Retrospective Analysis
At a Glance
Category
Detail
Condition
Relapsed or refractory multiple myeloma (R/R-MM) patients treated with BCMA-targeted CAR-T cell therapy infected with COVID-19 during the Omicron wave
Key Mechanisms
BCMA-targeted CAR-T cell therapy induces immune deficiency increasing infection risk; Omicron variant has higher transmissibility and vaccine resistance but lower severity than Delta
Target Population
Patients ≤75 years with R/R-MM who received BCMA-targeted CAR-T cell therapy between July 2018 and December 2022
Care Setting
Tertiary hospital setting with retrospective clinical data collection and follow-up
Key Highlights
High incidence of COVID-19 infection observed in R/R-MM patients post BCMA-targeted CAR-T therapy during Omicron surge
Severe cytokine release syndrome (CRS) occurred in 30.6% of patients during CAR-T therapy; overall response rate was 98%, with 67.3% achieving complete remission
COVID-19 severity classified as mild, moderate, or severe based on oxygen saturation and chest imaging; resolution defined by symptom clearance or negative testing
Guideline-Based Recommendations
Diagnosis
Use antigen or nucleic acid testing for SARS-CoV-2 to confirm COVID-19 infection
Classify COVID-19 severity by SpO2 levels and chest imaging findings
Management
Monitor patients closely for COVID-19 symptoms post CAR-T therapy due to immune deficiency
Manage CRS during CAR-T therapy per established grading criteria
Monitoring & Follow-up
Follow-up for COVID-19 resolution defined by symptom resolution or negative SARS-CoV-2 tests
Assess overall survival and COVID-19 duration using Kaplan–Meier estimator
Risks
Increased risk of severe COVID-19 due to immune dysfunction from MM and CAR-T therapy
Potential impaired vaccine response in BCMA-targeted CAR-T recipients
Patient & Prescribing Data
49 patients with R/R-MM treated with BCMA-targeted CAR-T cells, median age 60 years, majority DS stage III
High overall response rate (98%) to BCMA-targeted CAR-T therapy; significant incidence of CRS; COVID-19 infection risk remains elevated during Omicron variant surge
Clinical Best Practices
Obtain informed consent and adhere to ethical standards in data collection
Use standardized criteria (Lee criteria) to grade CRS during CAR-T therapy
Employ rigorous COVID-19 testing and classification protocols to guide clinical decisions
Perform statistical analyses to identify risk factors and outcomes in this patient population
