Abstract
BackgroundVery little is known about the risk that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral infection poses to cancer patients, many of whom are immune compromised causing them to be more susceptible to a host of infections. As a precautionary measure, many clinical studies halted enrollment during the initial surge of the global Novel Coronavirus Disease (COVID-19) pandemic. In this case report, we detail the successful treatment of a relapsed and refractory multiple myeloma (MM) patient treated with an anti-B cell maturation antigen (BCMA) chimeric antigen receptor (CAR) T cell therapy immediately following clinical recovery from COVID-19.Case presentationThe 57 year old Caucasian male patient had a 4-year history of MM and was considered penta-refractory upon presentation for CAR T cell therapy. He had a history of immunosuppression and received one dose of lymphodepleting chemotherapy (LDC) the day prior to COVID-19 diagnosis; this patient was able to mount a substantial immune response against the SARS-CoV-2 virus, and antiviral antibodies remain detectable 2 months after receiving anti-BCMA CAR T cell therapy. The recent SARS-CoV-2 infection in this patient did not exacerbate CAR T-associated cytokine release syndrome (CRS) and conversely the CAR T cell therapy did not result in COVID-19-related complications. One month after CAR T cell infusion, the patient was assessed to have an unconfirmed partial response per International Myeloma Working Group (IMWG) criteria.ConclusionOur case adds important context around treatment choice for MM patients in the era of COVID-19 and whether CAR T therapy can be administered to patients who have recovered from COVID-19. As the COVID-19 global pandemic continues, the decision of whether to proceed with CAR T cell therapy will require extensive discussion weighing the potential risks and benefits of therapy. This case suggests that it is possible to successfully complete anti-BCMA CAR T cell therapy after recovery from COVID-19.CRB-402 study registered 6 September 2017 at clinicaltrials.gov (NCT03274219).
Highlights
Very little is known about the risk that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral infection poses to cancer patients, many of whom are immune compromised causing them to be more susceptible to a host of infections
Our case adds important context around treatment choice for MM patients in the era of COVID-19 and whether chimeric antigen receptor (CAR) T therapy can be administered to patients who have recovered from COVID-19
Madduri et al J Med Case Reports (2021) 15:90 patients, it is unclear whether the immunosuppression resulting from conditioning regimens used with CAR T cell therapy may pose an increased risk of infection with severe acute respiratory syndrome coronavirus 2 (SARSCoV-2)
Summary
Very little is known about the risk that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral infection poses to cancer patients, many of whom are immune compromised causing them to be more susceptible to a host of infections. This case suggests that it is possible to successfully complete anti-BCMA CAR T cell therapy after recovery from COVID-19. We report the first case to our knowledge of an MM patient safely treated with anti-BCMA CAR T cell therapy immediately after clinical recovery from COVID-19.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have