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MINI-REVIEW

How to manage chimeric antigen receptor T cell recipients upon encountering COVID-19 infection?

Tingting Zhang1,2† ,  Ganggang Wang1,2† ,  Boyan Zhang3† ,  Shuling Hou1,2* ,  Dong Song1,2* ,  Li Li1,2*
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1 Department of lymphoma, Cancer Center, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
2 Sino-German Joint Oncological Research Laboratory, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, Shanxi, China
3 Department of Pharmaceutics, School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
CP, 3742
Submitted: 23 May 2024 | Accepted: 12 July 2024 | Published: 26 December 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Chimeric antigen receptor (CAR) T cell recipients are considered at higher risk of SARS-CoV-2 infection, more severe COVID-19 illness, and poorer outcomes compared to the general population due to their impaired humoral immunity. Managing COVID-19 in these vulnerable patients is particularly challenging. In this review, we provide a brief overview of the characteristics of COVID-19 infection in CAR-T cell recipients, including the pre-treatment assessments and the timing for initiating CAR-T cell therapy, the treatment of COVID-19 during CAR-T cell therapy, and considerations for SARS-CoV-2 vaccination. Our aim is to offer practical strategies to help clinicians conduct safer and more effective CAR-T cell therapies in the post-COVID-19 pandemic era. The therapeutic approach to COVID-19 in this patient population must be individualized. In regions affected by the SARS-CoV-2 outbreak, CAR-T cell therapy is recommended to be conducted at well-established medical centers with expertise in CAR-T. This approach ensures optimal, comprehensive care throughout the treatment process, with the involvement of a multidisciplinary team being essential to the patient’s care.

Keywords
SARS-CoV-2
COVID-19
CAR-T
Hematological malignancies
Treatment
Vaccine
Funding
This work was supported by grants from the National Natural Science Foundation of China (No. 82300227 to Dr. Tingting Zhang) and Fundamental Research Program of Shanxi Province (No. 202303021222318 to Dr. Tingting Zhang and No.202203021221246 to Dr. Dong Song).
Conflict of interest
The authors declare that they have no competing interests.
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