P1574: EFFICACY AND SAFETY OF TIXAGEVIMAB AND CILGAVIMAB (EVUSHELD) IN PATIENTS WITH HEMATOLOGICAL MALIGNANCIES

Abstract Topic: 30. Infections in hematology (incl. supportive care/therapy)

Background: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV 2). The presence of hematologic malignancy is associated with a high risk of mortality from COVID-19. Tixagevimab and cilgavimab (Evusheld) are SARS-Cov-2 neutralizing monoclonal antibodies derived from convalescent plasma. Evusheld is a perspective drug for the prevention and treatment of COVID-19 in patients with hematological diseases.

Aims: To evaluate the safety and efficacy of the Evusheld in patients with hematological diseases, to identify complications arising immediately after administration of the drug and delayed complications, as well as the frequency of reinfection of COVID-19 after administration of a monoclonal antibodies (moAb).

Methods: This study included 96 patients with a median age 50 (range 22-84 years, m=54, f=42). The distribution by nosology is: 6 pts with hemophilia A, 3 pts with von Willebrand disease, 2 pts with chronic myeloproliferative disease, 1 patient with paroxysmal nocturnal hemoglobinuria, 26 pts with acute leukemia (12 with AML, 12 with ALL, 2 with APL), 23 pts with multiple myeloma, 17 pts with NHLs, 4 pts with HL, 4 pts with hairy cell leukemia, 4 pts with MDS, 4 pts with CLL. 10 pts were after allo-hsct (2 pts with NHLs, 1 pt with multiple myeloma, 2 pts with AML, 1 pt with ALL, 1 pt with CLL, 3 pts with MDS),

Out of 96 patients 69 (71%) were administrated with prophylactic dose of Evusheld (150 + 150 mg i.m) and 27 (28%) patients were administrated with therapeutic dose of Evusheld (300 + 300 mg i.m) since May 2022 till Aug 2022. Patients with hemophilia А received a prophylactic dose of factor VIII before the administration of Evusheld.

Results: Median follow up was 6 months (range 4-9).

In group of patients who received prophylactic dose no obvious side effects were observed after administration of the moAb. Symptomatic COVID-19 occurred in 19 %, n=9 (4 patients with mild illness, 2 patients with moderate illness, 2 patients with severe illness). Mortality rate was 0%. No clinical manifestations of acute respiratory infection were recorded in the remaining patients (n=60) during the follow-up period.

In group of patients who received therapeutic dose of moAb no obvious side effects were observed after administration of moAb. Symptomatic COVID-19 occurred in 15 %, n=4 (4 patients with mild illness). Mortаlity rate was 0%. No clinical manifestations of acute respiratory infection were recorded in the remaining patients (n=23) during the follow-up period

In patients with hemophilia, hematomas at injection sites in both therapeutic and prophylactic groups were not recorded.

Summary/Conclusion: In our study, Evusheld in patients with hematological diseases had a favorable safety profile, reduced SARS-CoV-2 infection and minimized the risk of developing severe Covid-19.

Keywords: Acute leukemia, Hematological malignancy, COVID-19, Monoclonal antibody