Multidisciplinary recommendations for the management of CAR-T recipients in the post-COVID-19 pandemic era

Tingting Zhang; Weiwei Tian; Shuang Wei; Xinyi Lu; Jing An; Shaolong He; Jie Zhao; Zhilin Gao; Li Li; Ke Lian; Qiang Zhou; Huilai Zhang; Liang Wang; Liping Su; Huicong Kang; Ting Niu; Ailin Zhao; Jing Pan; Qingqing Cai; Zhenshu Xu; Wenming Chen; Hongmei Jing; Peng Li; Wanhong Zhao; Yang Cao; Jianqing Mi; Tao Chen; Yuan Chen; Ping Zou; Veronika Lukacs-Kornek; Christian Kurts; Jian Li; Xiansheng Liu; Qi Mei; Yicheng Zhang; Jia Wei

doi:10.1186/s40164-023-00426-x

Multidisciplinary recommendations for the management of CAR-T recipients in the post-COVID-19 pandemic era

Exp Hematol Oncol. 2023 Jul 27;12(1):66. doi: 10.1186/s40164-023-00426-x.

Authors

Tingting Zhang^#¹, Weiwei Tian^#², Shuang Wei^#^{3

4

5}, Xinyi Lu^{2

5}, Jing An⁶, Shaolong He^{2

5}, Jie Zhao^{2

5}, Zhilin Gao^{2

5}, Li Li^{1

5}, Ke Lian^{1

5}, Qiang Zhou^{7

8}, Huilai Zhang⁹, Liang Wang¹⁰, Liping Su¹¹, Huicong Kang^{12

13}, Ting Niu¹⁴, Ailin Zhao¹⁴, Jing Pan¹⁵, Qingqing Cai¹⁶, Zhenshu Xu¹⁷, Wenming Chen¹⁸, Hongmei Jing¹⁹, Peng Li²⁰, Wanhong Zhao²¹, Yang Cao^{22

23}, Jianqing Mi²⁴, Tao Chen²⁵, Yuan Chen^{26

27}, Ping Zou²⁸, Veronika Lukacs-Kornek²⁹, Christian Kurts²⁹, Jian Li²⁹, Xiansheng Liu^{30

31}, Qi Mei^{32

33}, Yicheng Zhang^{34

35}, Jia Wei^{36

37

38

39}

Affiliations

¹ Cancer Center, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, Shanxi, China.
² Department of Hematology, Tongji Shanxi Hospital, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Taiyuan, 030032, Shanxi, China.
³ Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
⁴ Department of Respiratory and Critical Care Medicine, Tongji Shanxi Hospital, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Taiyuan, 030032, Shanxi, China.
⁵ Sino-German Joint Oncological Research Laboratory, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, 030032, Shanxi, China.
⁶ School of Public Health, Shanxi Medical University, Taiyuan, 030000, Shanxi, China.
⁷ Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
⁸ Department of Cardiovascular Medicine, Tongji Shanxi Hospital, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Taiyuan, 030032, Shanxi, China.
⁹ Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, 300060, China.
¹⁰ Department of Hematology, Beijing TongRen Hospital, Capital Medical University, Beijing, 100730, China.
¹¹ Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, 030032, Shanxi, China.
¹² Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
¹³ Department of Neurology, Tongji Shanxi Hospital, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Taiyuan, 030032, Shanxi, China.
¹⁴ Department of Hematology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
¹⁵ State Key Laboratory of Experimental Hematology, Boren Biotherapy Translational Laboratory, Boren Clinical Translational Center, Beijing GoBroad Boren Hospital, Beijing, 100070, China.
¹⁶ Sun Yat-Sen University Cancer Center, Guangzhou, 510060, Guangdong, China.
¹⁷ Hematology Department, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fuzhou, 350001, Fujian, China.
¹⁸ Department of Hematology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China.
¹⁹ Department of Hematology, Peking University Third Hospital, Beijing, 100191, China.
²⁰ Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, 510535, Guangdong, China.
²¹ Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shanxi, China.
²² Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
²³ Immunotherapy Research Center for Hematologic Diseases of Hubei Province, Wuhan, 430030, Hubei, China.
²⁴ Shanghai Institute of Hematology, Ruijin Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
²⁵ Department and Institute of Infectious Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
²⁶ Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
²⁷ Department of Geriatrics, Tongji Shanxi Hospital, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Taiyuan, 030032, Shanxi, China.
²⁸ Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China.
²⁹ Institute of Molecular Medicine and Experimental Immunology, University Clinic of Rheinische Friedrich-Wilhelms-University, 53111, Bonn, Germany.
³⁰ Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China. xsliu@tjh.tjmu.edu.cn.
³¹ Department of Respiratory and Critical Care Medicine, Tongji Shanxi Hospital, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Taiyuan, 030032, Shanxi, China. xsliu@tjh.tjmu.edu.cn.
³² Sino-German Joint Oncological Research Laboratory, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, 030032, Shanxi, China. borismq@163.com.
³³ Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China. borismq@163.com.
³⁴ Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China. yczhang@tjh.tjmu.edu.cn.
³⁵ Immunotherapy Research Center for Hematologic Diseases of Hubei Province, Wuhan, 430030, Hubei, China. yczhang@tjh.tjmu.edu.cn.
³⁶ Department of Hematology, Tongji Shanxi Hospital, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Taiyuan, 030032, Shanxi, China. jiawei@tjh.tjmu.edu.cn.
³⁷ Sino-German Joint Oncological Research Laboratory, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, 030032, Shanxi, China. jiawei@tjh.tjmu.edu.cn.
³⁸ Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China. jiawei@tjh.tjmu.edu.cn.
³⁹ Immunotherapy Research Center for Hematologic Diseases of Hubei Province, Wuhan, 430030, Hubei, China. jiawei@tjh.tjmu.edu.cn.

^# Contributed equally.

Abstract

The outbreak of coronavirus disease 2019 (COVID-19) posed an unprecedented challenge on public health systems. Despite the measures put in place to contain it, COVID-19 is likely to continue experiencing sporadic outbreaks for some time, and individuals will remain susceptible to recurrent infections. Chimeric antigen receptor (CAR)-T recipients are characterized by durable B-cell aplasia, hypogammaglobulinemia and loss of T-cell diversity, which lead to an increased proportion of severe/critical cases and a high mortality rate after COVID-19 infection. Thus, treatment decisions have become much more complex and require greater caution when considering CAR T-cell immunotherapy. Hence, we reviewed the current understanding of COVID-19 and reported clinical experience in the management of COVID-19 and CAR-T therapy. After a panel discussion, we proposed a rational procedure pertaining to CAR-T recipients with the aim of maximizing the benefit of CAR-T therapy in the post COVID-19 pandemic era.

Keywords: CAR T-cell; COVID-19; Hematological malignancies; Recommendations; SARS-CoV-2; Treatment.

Publication types

Review

Abstract

Publication types

Grants and funding