Pre-exposure prophylaxis with tixagevimab/cilgavimab (AZD7442) prevents severe SARS-CoV-2 infection in recipients of allogeneic hematopoietic stem cell transplantation during the Omicron wave: a multicentric retrospective study of SFGM-TC

J Hematol Oncol. 2022 Nov 28;15(1):169. doi: 10.1186/s13045-022-01387-0.

Abstract

Since the emergence of the Omicron variant of SARS-CoV-2, though considered less virulent, hospitalization and death rates among immunocompromised patients remain high, especially for poor responders to vaccination. We conducted a retrospective multicentric study to evaluate pre-exposure prophylaxis with AZD7442 (tixagevimab/cilgavimab) for preventing COVID-19 in adult allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients. Among the 161 patients of our cohort, 22 (14%) contracted COVID-19 after a median follow-up of 105 days, but no severe form was observed. Only one major adverse event was reported: an acute coronary syndrome, resolved without sequelae. Pending randomized controlled trial results, our data support the use of AZD7442 as pre-exposure prophylaxis for COVID-19 during Omicron wave in allo-HSCT patients who failed to develop humoral immunity to vaccination, to prevent severe and potentially lethal forms of SARS-CoV-2 infection.

Keywords: AZD7442; Allogeneic stem cell transplantation; Pre-exposure prophylaxis; SARS-CoV-2.

Publication types

  • Letter

MeSH terms

  • Adult
  • COVID-19* / prevention & control
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Pre-Exposure Prophylaxis*
  • Retrospective Studies
  • SARS-CoV-2

Substances

  • tixagevimab
  • cilgavimab
  • cilgavimab and tixagevimab drug combination

Supplementary concepts

  • SARS-CoV-2 variants