CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题：Successful early use of anti-SARS-CoV-2 monoclonal neutralizing antibodies in SARS-CoV-2 infected hematological patients - A Czech multicenter experience.
Successful early use of anti-SARS-CoV-2 monoclonal neutralizing antibodies in SARS-CoV-2 infected hematological patients - A Czech multicenter experience.
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COVID-19显著降低了血液病患者相较于普通人群的生存率。我们的前瞻性多中心项目分析了早期使用抗SARS-CoV-2刺突蛋白中和单克隆抗体（NmAbs）——bamlanivimab（72%）和casirivimab/imdevimab（28%）——在早期COVID-19血液病患者中的疗效。死亡率与575例未接受任何特异性抗COVID-19治疗的SARS-CoV-2阳性血液病患者对照队列进行了比较。共评估了88例血液病患者，最常见的 underlying 诊断为淋巴瘤、急性白血病和骨髓瘤（72%），NmAb给药后中位随访时间为97天。三分之一的患者（32%）在COVID-19诊断前接受过抗CD20单克隆抗体治疗。首次COVID-19症状至NmAb给药的中位时间为2天。给予NmAb时，分别有29%、57%、11%、2%和1%的患者处于无症状、轻度、中度、重度和危重度COVID-19。
80%的基线无症状患者在NmAb给药后仍保持无症状。NmAb给药后COVID-19症状的中位持续时间为2.5天。共有17%（15/88）的病例进展为重度/危重度COVID-19，bamlanivimab组在数值上高于casirivimab/imdevimab组（21% vs. 8%；p = 0.215），骨髓瘤（29%）、淋巴瘤（17%）和急性白血病（18%）分别如此。在最终随访期间，记录了9例死亡（10%）——全部发生在bamlanivimab之后（p = 0.056），其中8%归因于COVID-19。关于「未使用过 remdesivir/恢复期血浆」的患者，在我们的 NmAbs 治疗队列中，COVID-19 死亡率显著低于未接受治疗的 SARS-CoV-2 阳性血液病患者对照组（分别为 6% vs. 16%，p = 0.020）。
我们的研究验证了 NmAbs 在新诊断早期 COVID-19 血液病患者中早期使用的安全性和有效性，体现在减轻感染病程和降低死亡率方面。结果证实，casirivimab/imdevimab 联合方案相比 bamlanivimab 单药治疗具有更积极的效果。
COVID-19 significantly impairs survival rates among hematological patients when compared to the general population.
Our prospective multicentre project analyzed early administration of anti-SARS-CoV-2 spike protein neutralizing monoclonal antibodies (NmAbs) - bamlanivimab (72%) and casirivimab/imdevimab (28%) - efficacy among hematological patients with early-stage COVID-19. Mortality rate was compared to a control cohort of 575 SARS-CoV-2 positive hematological patients untreated with any specific anti-COVID-19 therapy. 88 hematological patients with lymphomas, acute leukemias, and myeloma as their most frequent underlying diagnoses (72%) were evaluated with a 97 days median follow-up after NmAb administration. One third of patients (32%) were treated with an anti-CD20 monoclonal antibody before COVID-19 diagnosis. Median time between first COVID-19 symptom and NmAb administration was 2 days. When administering NmAb, 29%, 57%, 11%, 2%, and 1% of our patients had asymptomatic, mild, moderate, severe, and critical degrees of COVID-19, respectively.
80% of baseline asymptomatic patients remained asymptomatic following NmAb administration. Median duration of COVID-19 symptoms after NmAb administration was 2. 5 days. Progression to severe/critical COVID-19 occurred among a total of 17% (15/88) of our cases and numerically higher with bamlanivimab versus casirivimab/imdevimab (21% vs. 8%; p = 0. 215), and myelomas (29%), lymphomas (17%) and acute leukemias (18%), respectively.
During final follow-up, nine deaths (10%) were recorded - all after bamlanivimab (p = 0. 056) with 8% attributed to COVID-19. Regarding "remdesivir/convalescent plasma naïve" patients, COVID-19 mortality rates were significantly lower in our NmAbs treated cohort compared to the control cohort of untreated SARS-CoV-2 positive hematological patients (6% vs. 16%, p = 0. 020), respectively.
Our study validated the safety and efficacy of NmAbs early use among hematological patients with newly diagnosed early-stage COVID-19 in terms of alleviating infection course and decreasing mortality. Results confirmed a more positive effect of a casirivimab/imdevimab combination versus bamlanivimab monotherapy.
在 PubMed 查看 → 出版商原文（DOI） 全文 PDF（PMC）· 可下载 治疗专题与资料阅读指南 资料来源与翻译说明 报告译文或资料问题 →
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