Conference Coverage

mRNA COVID-19 Vaccination Linked to Improved Survival After CAR T-Cell Therapy

Edited by:
Ashton L. Stahl

Key Highlights

  • mRNA SARS-CoV-2 vaccination was associated with lower 3-year all-cause mortality after CAR T-cell therapy.
  • The vaccinated cohort had higher odds of grade 1/2 cytokine release syndrome.
  • There was no significant difference in ICANS between vaccinated and unvaccinated cohorts.

mRNA SARS-CoV-2 vaccination was associated with significantly superior long-term survival among patients with hematologic malignancies who received CAR T-cell therapy, according to a multicenter real-world analysis published as a 2026 American Society of Clinical Oncology Annual Meeting abstract in the Journal of Clinical Oncology. The study evaluated whether mRNA vaccination affected survival outcomes and immunotoxicity profiles in a patient population vulnerable to cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome.

The researchers conducted a retrospective cohort study using the TriNetX global federated health research network. Patients with hematologic malignancies who received CAR T-cell therapy were identified using ICD-10 and RXNORM codes and stratified by receipt of an mRNA-based SARS-CoV-2 vaccine. Cohorts were 1:1 propensity score matched for age, sex, race, staging, and comorbidities. The primary outcome was all-cause mortality at 3 years; secondary outcomes included grade 1/2 and grade 3/4 cytokine release syndrome and ICANS, graded according to ASTCT criteria.

Study Findings

The study identified 3,199 patients who received CAR T-cell therapy, including 222 who received an mRNA vaccine and 2,977 who did not receive an mRNA vaccine. After propensity score matching, 218 patients remained in each cohort.

At 3 years, all-cause mortality was significantly lower among mRNA SARS-CoV-2 vaccine recipients than among nonrecipients, with a hazard ratio of 0.608 (95% CI, 0.411-0.901). In the study’s outcome table, the effect was reported as HR 0.61 (95% CI, 0.41-0.90; P = .01).

The mRNA vaccine group had higher odds of grade 1/2 cytokine release syndrome, with an odds ratio of 1.577 (95% CI, 1.056-2.356). The outcome table reported an OR of 1.58 (95% CI, 1.06-2.36; P = .03). The researchers noted insufficient cases of grade 3/4 cytokine release syndrome to compare the 2 cohorts. ICANS did not differ significantly between groups, with an OR of 0.8262 (95% CI, 0.522-1.37), reported in the table as 0.83 (95% CI, 0.52-1.37; P = .41).

Clinical Implications

According to the study authors, these findings provide early real-world clinical evidence that mRNA SARS-CoV-2 vaccination was associated with improved long-term survival among CAR T-cell recipients. The authors stated that the results build on early preclinical data on SARS-CoV-2 mRNA vaccines as well as type I interferon activity and noted that prospective validation is needed.

The authors reported limitations, including an insufficient number of cases of grade 3/4 cytokine release syndrome to compare the 2 cohorts.

Expert Commentary

“These findings provide early real-world clinical evidence and pave the way for prospective validation,” the researchers concluded.

Reference

Al-Nusair J, Elchouemi M, Eysha M, Hamza Zaki I, Hamed M, DeVito NC, Conejo-Garcia J, Abid MB. Impact of mRNA SARS-CoV-2 vaccination on CAR T-cell therapy outcomes in hematologic malignancies: a multi-center real-world analysis. J Clin Oncol. 2026;44(suppl 16):11001. doi:10.1200/JCO.2026.44.16_suppl.11001