Reduced Absolute Count of Monocytes in Patients Carrying Hematological Neoplasms and SARS-CoV2 Infection

Romano, Alessandra; Cerchione, Claudio; Conticello, Concetta; Filetti, S.; Bulla, Anna; Chiarenza, Annalisa; Fabro, Vittorio Del; Leotta, Salvatore; Markovic, Uroš; Motta, Giovanna; Parisi, Maria Giovanna; Stagno, Fabio; Palumbo, Giuseppe A.; Raimondo, Francesco Di

doi:10.3390/cancers14051173

Cited by 5 publications

(5 citation statements)

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“…This should be investigated in future studies, which can leverage the median values and ranges of the immune subsets analyzed here (Supplemental Table 4 ). In this regard, we and others have shown recently how immune profiling in blood was an independent prognostic factor of severe SARS-CoV-2 infection in individuals with and without blood cancer [ 23 – 26 ]. This becomes particularly relevant with the advent of BCMA-targeting bispecific antibodies, which deplete (tumor and normal) plasma cells and are associated with an increased incidence of infections [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Immune dysfunction prior to and during vaccination in multiple myeloma: a case study based on COVID-19

Martín-Sánchez,

Tamariz-Amador,

Guerrero

et al. 2024

Blood Cancer J.

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Infection is the leading cause of death in multiple myeloma (MM). However, the cellular composition associated with immune dysfunction is not defined. We analyzed immune profiles in the peripheral blood of patients with MM (n = 28) and B-cell chronic lymphoproliferative disorders (n = 53) vs. health care practitioners (n = 96), using multidimensional and computational flow cytometry. MM patients displayed altered distribution of most cell types (41/56, 73%), particularly within the B-cell (17/17) and T-cell (20/30) compartments. Using COVID-19 as a case study, we compared the immune response to vaccination based on 64,304 data points generated from the analysis of 1099 longitudinal samples. MM patients showed limited B-cell expansion linked to lower anti-RBD and anti-S antibody titers after the first two doses and booster. The percentages of B cells and CD4+ T cells in the blood, as well as the absolute counts of B cells and dendritic cells, predicted vaccine immunogenicity at different time points. In contrast with the humoral response, the percentage and antigen-dependent differentiation of SARS-CoV-2-specific CD8+ T cells was not altered in MM patients. Taken together, this study defined the cellular composition associated with immune dysfunction in MM and provided biomarkers such as the B-cell percentage and absolute count to individualize vaccination calendars.

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Section: Discussionmentioning

confidence: 99%

Immune dysfunction prior to and during vaccination in multiple myeloma: a case study based on COVID-19

Martín-Sánchez,

Tamariz-Amador,

Guerrero

et al. 2024

Blood Cancer J.

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“…In the studies investigating the mortality rate of hematological malignancy patients after they were infected with COVID-19, the overall mortality rates were reported to be up to 40%. 2 , 5 , 7 , 9 , 17 , 21 , 22 Vijenthira et al 4 reviewed the outcomes of 3377 patients with hematological malignancies and COVID-19 in a systematic review and meta-analysis. They found a higher mortality risk in older and hospitalized patients.…”

Section: Discussionmentioning

confidence: 99%

“…The ongoing treatment was defined as having the treatment within 30 days before COVID-19 diagnosis. 5,17 The laboratory parameters at the diagnosis of COVID-19 [leukocyte and platelet counts, lymphocyte percentage, C-reactive protein (CRP), and D-dimer] were investigated and categorized as low, normal, or high using each laboratory's lower and upper limits. In addition, we categorized the treatment modalities for hematological malignancies as conventional chemotherapy, targeted therapies (small-molecule inhibitors and monoclonal antibodies), immunotherapy (checkpoint inhibitors), and immunomodulatory.…”

Section: Methodsmentioning

confidence: 99%

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Impact of Covid-19 on Outcomes of Patients With Hematologic Malignancies: A Multi-Center, Retrospective Study

Açar

Güner

et al. 2022

Mediterr J Hematol Infect Dis

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Objectives: Patients with hematologic malignancies have a high risk of coronavirus disease 2019 (COVID-19) mortality. This study aimed to investigate the impact of COVID-19 on mortality rates in patients with various hematologic malignancies and to determine risk factors associated with all-cause mortality. Methods: A multi-center, observational retrospective analysis of patients with hematologic malignancies infected with COVID-19 between July 2020 and December 2021 was performed. Demographic data, clinical characteristics, and laboratory parameters were recorded. Patients were grouped as non-survivors and survivors. All-cause mortality was the primary outcome of the study. Results: There were 569 patients with a median age of 59 years. Non-Hodgkin lymphoma (22.0%) and multiple myelomas (18.1%) were the two most frequent hematologic malignancies. The all-cause mortality rate was 29.3%. The highest mortality rates were seen in patients with acute myeloid leukemia (44.3%), acute lymphoid leukemia (40.5%), and non-Hodgkin lymphoma (36.8%). The non-survivors were significantly older (p<0.001) and had more comorbidities (p<0.05). There were significantly more patients with low lymphocyte percentage (p<0.001), thrombocytopenia (p<0.001), and high CRP (p<0.001) in the non-survived patients. Cardiac comorbidities, (p=0.016), cytotoxic chemotherapy (p=0.024), low lymphocyte percentage (p=0.025), thrombocytopenia (p<0.0001), and high CRP values (p=0.017) were the independent risk factors for the prediction of mortality. Conclusions: In patients with hematologic malignancies, coexistent COVID-19 leads to a higher mortality rate in elderly patients with more comorbidities. Acute myeloid and lymphoid leukemia and non-Hodgkin lymphoma have the highest mortality rates. Cardiac diseases, cytotoxic chemotherapy, lymphopenia, thrombocytopenia, and high CRP are the independent risk factors for mortality in hematologic malignancy patients with COVID-19. Keywords: Covid; Hematologic Malignancy; Cytotoxic chemotherapy.

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“…On the other hand, an earlier study showed that patients with COVID-19 (including 90 patients with multiple myeloma with a prior history of autologous and allogeneic hematopoietic stem-cell transplantation (HSCT) have poor overall survival 18 . Interestingly, a recent study by Romano et al (2022) showed that absolute monocyte count prior to SARS-CoV-2 infection is predictive of the risk of overall survival in patients with heme malignancies 19 . Next, we focused on drug classes commonly used as anti-myeloma therapies.…”

Section: Discussionmentioning

confidence: 99%

Sample average treatment effect on the treated analysis using counterfactual explanation identifies BMT and SARS-CoV-2 vaccination as protective risk factors associated with COVID-19 severity and survival in patients with multiple myeloma

Mitra

Mukherjee

Mazumder

et al. 2022

Preprint

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Patients with multiple myeloma (MM), an age-dependent neoplasm of antibody-producing plasma cells, have compromised immune systems and might be at increased risk for severe COVID-19 outcomes. This study characterizes risk factors associated with clinical indicators of COVID-19 severity and all-cause mortality in myeloma patients utilizing NCATS' National COVID Cohort Collaborative (N3C) database. The N3C consortium is a large, centralized data resource representing the largest multi-center cohort of COVID-19 cases and controls nationwide (>16 million total patients, and >6 million confirmed COVID-19+ cases to date). Our cohort included myeloma patients (both inpatients and outpatients) within the N3C consortium who have been diagnosed with COVID-19 based on positive PCR or antigen tests or ICD-10-CM diagnosis code. The outcomes of interest include all-cause mortality (including discharge to hospice) during the index encounter and clinical indicators of severity (i.e., hospitalization/emergency department/ED visit, use of mechanical ventilation, or extracorporeal membrane oxygenation (ECMO)). Finally, causal inference analysis was performed using the propensity score matching (PSM) method. As of 05/16/2022, the N3C consortium included 1,061,748 cancer patients, out of which 26,064 were MM patients (8,588 were COVID-19 positive). The mean age at COVID-19 diagnosis was 65.89 years, 46.8% were females, and 20.2% were of black race. 4.47% of patients died within 30 days of COVID-19 hospitalization. Overall, the survival probability was 90.7% across the course of the study. Multivariate logistic regression analysis showed histories of pulmonary and renal disease, dexamethasone, proteasome inhibitor/PI, immunomodulatory/IMiD therapies, and severe Charlson Comorbidity Index/CCI were significantly associated with higher risks of severe COVID-19 outcomes. Protective associations were observed with blood-or-marrow transplant/BMT and COVID-19 vaccination. Further, multivariate cox proportional hazard analysis showed that high and moderate CCI levels, International Staging System (ISS) moderate or severe stage, and PI therapy were associated with worse survival, while BMT and COVID-19 vaccination were associated with lower risk of death. Finally, matched sample average treatment effect on the treated (SATT) confirmed the causal effect of BMT and vaccination status as top protective factors associated with COVID-19 risk among US patients suffering from multiple myeloma. To the best of our knowledge, this is the largest nationwide study on myeloma patients with COVID-19.

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Reduced Absolute Count of Monocytes in Patients Carrying Hematological Neoplasms and SARS-CoV2 Infection

Cited by 5 publications

References 66 publications

Immune dysfunction prior to and during vaccination in multiple myeloma: a case study based on COVID-19

Immune dysfunction prior to and during vaccination in multiple myeloma: a case study based on COVID-19

Impact of Covid-19 on Outcomes of Patients With Hematologic Malignancies: A Multi-Center, Retrospective Study

Sample average treatment effect on the treated analysis using counterfactual explanation identifies BMT and SARS-CoV-2 vaccination as protective risk factors associated with COVID-19 severity and survival in patients with multiple myeloma

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