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Comprehensive procedure for injecting Evusheld® for hematological diseases in a single institute

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Abstract

Tixagevimab and cilgavimab (EVA, Evusheld®), monoclonal antibody combination treatments, consisted of two neutralizing antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). EVA showed prophylactic and therapeutic effects against coronavirus disease 2019. The Japanese Society of Hematology recommended EVA for such patients with active treatment, but each institution decided on comprehensive administration. We develop a systematic procedure for comprehensive EVA injection prophylactically in patients with hematological malignancies without any over/under-indication. We listed all patients with the required indications from November 2022 to March 2023. We included 178 cases, 84 females and 94 males, with a median age of 70 (range: 19–90) years. Underlying diseases are myeloid neoplasms in 36 (20%), lymphoid neoplasms in 75 (73%), and others. Indications were intensively hematological malignancy treatment, rituximab treatment within 12 months, burton kinase inhibitor treatment, after chimeric antigen receptor T cell immunotherapy, and after stem cell transplantation in 74 (41%), 73 (41%), 3 (2%), 5 (3%), and 23 (13%) cases, respectively. Of the 178 cases, 22 (12.4%) refused EVA injection. Further, 42 and 136 cases were administered outpatient and inpatient, respectively. Over 95% of the listed cases received EVA injection within 3 months. No severe toxicities were observed among them (N = 156), and 8 (5.2%) cases had breakthrough SARS-CoV-2 infection, which was significantly lower (P = 0.02) than those without EVA (4 [18.2%] of 22 cases). Both groups showed no moderate or severe infection cases. This single-center experience showed that comprehensive EVA injection management effectively generated safer completion with preferable clinical impact.

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Funding

This work was supported by internal funding from JSPS KAKENHI Grant Numbers JP 22K06768 and JP23K11850. We do not have any other financial relationships to disclose. The funder had no role in the design, data collection, data analysis, or reporting of this study.

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Authors and Affiliations

  1. Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, 1750–1 Ikenobe, Miki-Town, Kita-County, Kagawa, 761-0793, Japan

    Osamu Imataki, Shunsuke Yoshida, Tomoya Ishida, Makiko Uemura, Haruyuki Fujita & Norimitsu Kadowaki

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  1. Osamu Imataki
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  2. Shunsuke Yoshida
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  3. Tomoya Ishida
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  4. Makiko Uemura
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  5. Haruyuki Fujita
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  6. Norimitsu Kadowaki
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Contributions

OI and MU managed the patient’s case, contributed to the literature search, and wrote the manuscript. HF and MU made substantial contributions to the concept and design of this report. HF qualified the patient’s data and suggested important intellectual content. SY, TI, and NK participated in critical discussions. MU was involved in the supervision of the manuscript and managed the research. All authors have approved the final version of the manuscript.

Corresponding author

Correspondence to Osamu Imataki.

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Statement of ethics

This study was conducted ethically in accordance with the World Medical Association Declaration of Helsinki. The subjects have provided written informed consent to publish their case (including publication of images).

Study approval statement

This study protocol was reviewed and approved by the Kagawa University Hospital Institutional Review Board (approval number 2022–202.

Consent to participate statement

Written informed consent was obtained from the patients for publication of this study.

Competing interests

The authors declare no competing interests.

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Imataki, O., Yoshida, S., Ishida, T. et al. Comprehensive procedure for injecting Evusheld® for hematological diseases in a single institute. Ann Hematol (2024). https://doi.org/10.1007/s00277-024-05792-y

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  • DOI: https://doi.org/10.1007/s00277-024-05792-y

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