Outpatient Monoclonal Antibody Treatment Prevented Hospitalization in Patients with COVID-19 and Hematologic Malignancy

In patients with COVID-19 and hematologic malignancy and hematopoietic cell transplantation (HM/HCT), early administration of SARS-CoV-2-specific mAb prevented hospitalization and death when given in the outpatient setting, according to a study published in Transplant Infectious Disease.

However, “Among patients who received mAbs at or after hospital admission, the risk of COVID-19 disease progression and death remains significant,” wrote corresponding author Ra’ed Jabr, MBBS, of the Mayo Clinic Health System Division of Infectious Diseases in Eau Claire, WI, and coauthors.

The study was a retrospective chart review of 59 patients with HM/HCT at the University of Miami Hospital and Sylvester Comprehensive Cancer Center in Miami, FL, who received casirivimab–imdevimab or bamlanivimab for mild to moderate COVID-19 between November 21, 2020, and September 30, 2021. 

Among the patients, 46 received mAbs as outpatients. Only 4 visited the emergency department afterward (at days 10, 11, 15, and 35), and none required hospital admission, according to the study.

Among the 13 patients who received mAbs while hospitalized, 5 were admitted with neutropenic fever, 4 were already hospitalized for transplantation and cellular therapy, 3 were admitted for COVID-19 symptom monitoring, and 1 was admitted for acute kidney injury, the study showed. Three patients died, at 14, 35, and 59 days after mAb administration. Two of the deaths were attributed to COVID-19. 

One patient experienced an immediate infusion reaction to bamlanivimab.

“Larger studies of the use of mAb therapy to treat COVID-19 in this population are needed,” researchers advised.

Reference:
Jabr R, Khatri A, Anderson AD, et al. Early administration of SARS-CoV-2 monoclonal antibody reduces the risk of mortality in hematologic malignancy and hematopoietic cell transplant patients with COVID-19. Transpl Infect Dis. Published online January 27, 2023. doi:10.1111/tid.14006