Table 1.
Baseline clinical characteristics and immunologic findings of the pre- and post-CAR-T-cell therapy cohorts
| Demographics | Diagnosis and treatments prior to CAR-T-cell therapy | CAR-T-cell therapy and vaccine | Baseline immunologic findings* | ||||||||
| Study ID | Age group, years | Sex | Underlying diagnosis† | Prior HCT, months to vaccine | mAb within prior 6 months before vaccine‡ | CAR-Tx target§ | Months, CAR-Tx to vaccine | Vaccine type¶ | IgG, mg/dL | CD19+ B cells /µL | CD4+ T cells /µL |
| Pre-CAR-T cohort | |||||||||||
| Individuals with an antibody response to ≥1 vaccine strain | |||||||||||
| Pre-4 | 18–60 | F | MM | yes | BCMA | IIV4 | 21 | 21.0 | 470 | ||
| Pre-5 | 61–75 | M | MM | Auto, 43 | yes | BCMA | IIV4 | 591 | 87.2 | 436 | |
| Individuals without antibody responses | |||||||||||
| Pre-1 | 18–60 | M | ALL | yes | CD19 | IIV4 | 376 | 4.7 | 236 | ||
| Pre-2 | 18–60 | M | NHL | Auto, 19 | CD20 | IIV4 | 552 | <0.1 | 103 | ||
| Pre-3 | 18–60 | M | MM | Auto, 32 | BCMA | IIV4 | 46 | 47.2 | 433 | ||
| Post-CAR-T cohort | |||||||||||
| Individuals with an antibody response to ≥1 vaccine strain | |||||||||||
| Post-1 | 18–60 | M | ALL | Allo, 50 | CD19 | 16 | IIV4 | 823 | 401.2 | 392 | |
| Post-4 | 18–60 | F | CLL | CD19 | 50 | ccIIV4 | 334 | 14.4 | 488 | ||
| Post-11 | 61–75 | M | NHL | CD19 | 50 | ccIIV4 | 189 | 0 | 501 | ||
| Post-13 | 61–75 | M | MM | Auto, 86 | BCMA | 14 | aIIV3 | 290 | 164.7 | 317 | |
| Individuals without antibody responses | |||||||||||
| Post-2 | 18–60 | F | ALL | Allo, 31 | CD19 | 13 | ccIIV4 | 371 | 0 | 176 | |
| Post-3 | 18–60 | F | ALL | Allo, 60 | CD19 | 57 | IIV4 | 310 | <0.1 | 152 | |
| Post-5 | 61–75 | M | CLL | CD19 | 54 | IIV4 | 217 | <0.1 | 480 | ||
| Post-6 | 61–75 | F | CLL | CD19 | 21 | IIV3-HD | 286 | 2.8 | 332 | ||
| Post-7 | 18–60 | M | NHL | CD19 | 19 | IIV4** | 527 | <0.1 | 394 | ||
| Post-8 | 18–60 | M | NHL | CD19 | 19 | IIV4 | 416 | 0.9 | 353 | ||
| Post-9 | 18–60 | F | NHL | Auto, 48 | CD19 | 34 | IIV4 | 447 | 94.7 | 504 | |
| Post-10 | 61–75 | M | NHL | CD19 | 24 | IIV4 | 364 | 207.3 | 303 | ||
| Post-12 | 61–75 | M | NHL | CD19 | 20 | IIV | 324 | 0.3 | 304 | ||
Additional information is provided in online supplemental tables 1 and 2. Blank fields indicate not applicable. Baseline is defined as the day of the baseline blood sample prior to vaccination.
*Lower limit of normal; IgG, 610 mg/dL; CD19+ B cells, 100 cells/µL; CD4+ T cells, 500 cells/µL.
†All individuals in the pre-CAR-T cohort had relapsed/refractory disease at baseline. All individuals in the post-CAR-T cohort had complete remission or very good partial remission at baseline.
‡Monoclonal antibodies were: ‘pre-1’, blinatumomab; ‘pre-4’ and ‘pre-5’, daratumumab.
§CAR-T-cell protocols are depicted in online supplemental table S1.
¶Vaccine strains were: A/Brisbane/02/2018 (H1N1)pdm09-like virus, A/Kansas/14/2017 (H3N2)-like virus, B/Colorado/06/2017-like virus (B/Victoria/2/87 lineage) for IIV3, with the addition of a B/Phuket/3073/2013-like virus (B/Yamagata/16/88 lineage) for IIV4.
**One of the 13 individuals in the post-CAR-T cohort did not receive an influenza vaccine in the prior season.
aIIV3, adjuvant trivalent inactivated influenza vaccine; ALL, acute lymphoblastic leukemia; Allo, allogeneic; Auto, autologous; BCMA, B cell maturation antigen; CAR-T-cell, chimeric antigen receptor-modified T cell; CAR-Tx, CAR-T-cell therapy; cc, cell culture based; CLL, chronic lymphocytic leukemia; F, female; HCT, hematopoietic cell transplant; HD, high dose; IIV3, trivalent inactivated influenza vaccine; IIV4, quadrivalent inactivated influenza vaccine; M, male; mAb, B cell lineage targeted monoclonal antibody; MM, multiple myeloma; NHL, non-Hodgkin's lymphoma.