PMID- 36704987 OWN - NLM STAT- MEDLINE DCOM- 20230224 LR - 20230224 IS - 1399-3062 (Electronic) IS - 1398-2273 (Linking) VI - 25 IP - 1 DP - 2023 Feb TI - Early administration of SARS-CoV-2 monoclonal antibody reduces the risk of mortality in hematologic malignancy and hematopoietic cell transplant patients with COVID-19. PG - e14006 LID - 10.1111/tid.14006 [doi] AB - BACKGROUND: Data on severe acute respiratory distress syndrome coronavirus 2 monoclonal antibody (SARS-CoV-2-specific mAb) use in hematologic malignancy and hematopoietic cell transplantation (HM/HCT) patients are limited. Here, we describe our experience with the use of casirivimab-imdevimab or bamlanivimab for the treatment of coronavirus disease 2019 (COVID-19) in HM/HCT patients. METHODS: This was a retrospective chart review at the University of Miami Hospital and Sylvester Comprehensive Cancer Center for HM/HCT patients with COVID-19 who received casirivimab-imdevimab or bamlanivimab from November 21, 2020, to September 30, 2021. Outcomes measured were mortality, hospital admission, and infusion reaction to SARS-CoV-2-specific mAbs. RESULTS: We identified 59 HM/HCT patients with mild to moderate COVID-19 who received casirivimab-imdevimab or bamlanivimab. Median age was 57 years (interquartile range [IQR]: 45-65). Among the 59 patients, 25 (42%) received cellular therapy: 14 (24%) had undergone allogeneic HCT, nine (15%) autologous HCT, and two (3%) received chimeric antigen receptor T-cell therapy. The median time from COVID-19 symptom onset to SARS-CoV-2-specific mAb administration was 4 (IQR: 3-6) days. Forty-six (78%) patients received SARS-CoV-2-specific mAbs as outpatients and 13 (22%) patients received SARS-CoV-2-specific mAbs during hospitalization. Among patients who received SARS-CoV-2-specific mAbs as outpatients, only four (9%) visited the emergency department at days 10, 11, 15, and 35 after SARS-CoV-2-specific mAb administration. None of these four patients required hospital admission. Among the hospitalized patients, five (38%) were admitted to the hospital with neutropenic fever, four (31%) were already hospitalized for transplantation and cellular therapy, three (23%) were admitted for monitoring of COVID-19 symptoms, and one (8%) was admitted with acute kidney injury. Three hospitalized patients (23%) died at 14, 35, and 59 days after SARS-CoV-2-specific mAb administration; two of these three deaths were attributed to COVID-19 infection. One patient developed an immediate infusion reaction to bamlanivimab, and no infusion reactions were reported to casirivimab-imdevimab use. CONCLUSION: During the alpha and delta variant surges, early administration of bamlanivimab or casirivimab-imdevimab prevented hospitalization and death when given in the outpatient setting. Among patients who received mAbs at or after hospital admission, the risk of COVID-19 disease progression and death remains significant. Larger studies of the use of mAb therapy to treat COVID-19 in this population are needed. CI - (c) 2023 Wiley Periodicals LLC. FAU - Jabr, Ra'ed AU - Jabr R AUID- ORCID: 0000-0001-6514-4206 AD - Division of Infectious Diseases, Mayo Clinic Health System, Eau Claire, Wisconsin, USA. FAU - Khatri, Akshay AU - Khatri A AUID- ORCID: 0000-0001-5821-048X AD - Division of Infectious Diseases, UnityPoint Health, Des Moines, Iowa, USA. FAU - Anderson, Anthony D AU - Anderson AD AUID- ORCID: 0000-0002-2765-582X AD - Department of Pharmacy, University of Miami Health System, Miami, Florida, USA. FAU - Garcia, Leopoldo Cordova AU - Garcia LC AD - Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA. FAU - Viotti, Julia Bini AU - Viotti JB AD - Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA. FAU - Natori, Yoichiro AU - Natori Y AUID- ORCID: 0000-0002-4938-125X AD - Miami Transplant Institute, Miami, Florida, USA. FAU - Raja, Mohammed AU - Raja M AUID- ORCID: 0000-0003-4324-5748 AD - Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA. FAU - Camargo, Jose F AU - Camargo JF AUID- ORCID: 0000-0001-9584-5011 AD - Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA. FAU - Morris, Michele I AU - Morris MI AD - Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA. LA - eng PT - Journal Article DEP - 20230127 PL - Denmark TA - Transpl Infect Dis JT - Transplant infectious disease : an official journal of the Transplantation Society JID - 100883688 RN - 0 (Antibodies, Monoclonal) RN - 0 (Antibodies, Viral) RN - SARS-CoV-2 variants SB - IM MH - Humans MH - Middle Aged MH - SARS-CoV-2 MH - *Hematopoietic Stem Cell Transplantation MH - Retrospective Studies MH - *COVID-19 MH - *Hematologic Neoplasms MH - Antibodies, Monoclonal MH - Antibodies, Viral OTO - NOTNLM OT - COVID-19 OT - hematologic malignancy OT - monoclonal antibody EDAT- 2023/01/28 06:00 MHDA- 2023/02/25 06:00 CRDT- 2023/01/27 04:23 PHST- 2022/09/18 00:00 [revised] PHST- 2022/04/28 00:00 [received] PHST- 2022/10/12 00:00 [accepted] PHST- 2023/01/28 06:00 [pubmed] PHST- 2023/02/25 06:00 [medline] PHST- 2023/01/27 04:23 [entrez] AID - 10.1111/tid.14006 [doi] PST - ppublish SO - Transpl Infect Dis. 2023 Feb;25(1):e14006. doi: 10.1111/tid.14006. Epub 2023 Jan 27.