BACKGROUND:The authors sought to study the risk factors associated with severe outcomes in hospitalized coronavirus disease 2019 (COVID-19) patients with cancer. METHODS: The authors queried the New York University Langone Medical Center's records for hospitalized patients who were polymerase chain reaction-positive for severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) and performed chart reviews on patients with cancer diagnoses to identify patients with active cancer and patients with a history of cancer. Descriptive statistics were calculated and multivariable logistic regression was used to determine associations between clinical, demographic, and laboratory characteristics with outcomes, including death and admission to the intensive care unit. RESULTS: A total of 4184 hospitalized SARS CoV-2+ patients, including 233 with active cancer, were identified. Patients with active cancer were more likely to die than those with a history of cancer and those without any cancer history (34.3% vs 27.6% vs 20%, respectively; P < .01). In multivariable regression among all patients, active cancer (odds ratio [

can then selectively target and kill cells expressing the tumor antigen (Fig. 1). Prior attempts at similar T-cell-mediated immunotherapy led to disappointing results, with little to no responses elicited. Earlier models of T cell immunotherapy transduced T cells that contained only extracellular antigen receptors to recognize tumor cells. Such constructs were unable to mount sufficient immune responses to overcome tumor cells, despite their recognition of the cells (1, 2). The current CAR T cell therapies in development differ from past efforts by including intracellular costimulatory domains, such as CD28 or 4-1BB, and CD3ζ signaling domains for optimization of the T cell response. Such domains amplify the ability of the CAR T cells to mount an immune response against tumors, and recent data suggest that these newer, second-generation constructs are leading to responses to treatment for many patients (3-5). Clinical trials have investigated CAR T cells in several tumor types, using CAR T cells with different extracellular and intracellular domains. The approved therapy, tisagenlecleucel (Kymriah), often previously referred to as CTL019 or "CART-19," targets CD19, which is highly expressed in B cell neoplasms such as acute lymphoblastic leukemia (ALL; the approved indication), and has demonstrated activity in chronic lymphocytic leukemia (CLL) and non-Hodgkin lymphoma (NHL). B cell maturation antigen (BCMA), has also been identified as a potential tumor target, expressed broadly on myeloma cells and normal plasma cells (6). CAR T cell therapies have demonstrated significant improvements in overall response and survival in several tumor types among relapsed and refractory patients with historically poor outcomes.

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