{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:19:36Z","timestamp":1760145576607,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Patients with hematologic malignancies still face a significant risk of severe coronavirus disease 2019 (COVID-19). The severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2)-neutralizing monoclonal antibody combination tixagevimab\/cilgavimab (TIX\/CGB) could be administered to immunocompromised patients for pre-exposure prophylaxis (PrEP) before the emergence of TIX\/CGB-resistant COVID-19 Omicron variants. TIX\/CGB application could be carried out regardless of the host\u2019s immune response to previous active SARS-CoV-2 vaccinations or infections. Because the efficacy of COVID-19 PrEP remains unclear, especially in SARS-CoV-2-seropositive patients, German national guidelines recommended TIX\/CGB PrEP only for SARS-CoV-2-seronegative patients in addition to an intensified active vaccination schedule. Having followed these guidelines, we now report the characteristics and outcomes of 54 recipients of TIX\/CGB PrEP in SARS-CoV-2-seronegative patients with hematological disease from a German tertiary medical center and compare them to 125 seropositive patients who did not receive any PrEP. While the number of patients with B-cell lymphomas was significantly higher in the seronegative cohort (33 (61%) vs. 18 (14%) cases, p &lt; 0.01), patients with myeloid diseases were significantly more frequent in the seropositive cohort (51 (41%) vs. 5 (9%) cases, p &lt; 0.01). Strikingly, patients who had undergone allogeneic hematopoietic stem cell transplantation were significantly more likely (forty-nine (39%) vs. six (11%) cases, p &lt; 0.01) to be SARS-CoV-2 seropositive. We observed that prophylactic application of TIX\/CGB PrEP to a highly vulnerable group of SARS-CoV-2-seronegative patients resulted in a similar number of COVID-19 breakthrough infections compared to the untreated seropositive control group (16 (32%) vs. 39 (36%), p = 0.62) and comparable COVID-19-related outcomes like hospitalization and oxygen requirement throughout an extended follow-up period of 12 months. In conclusion, our results support the tailored approach of administering TIX\/CGB PrEP only to SARS-CoV-2-seronegative patients during the COVID-19 pandemic and might provide a rationale for similar strategies during future outbreaks\/diseases, especially in times of initial limited availability and\/or financial constraints.<\/jats:p>","DOI":"10.3390\/vaccines12080871","type":"journal-article","created":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T12:38:20Z","timestamp":1722515900000},"page":"871","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Tixagevimab\/Cilgavimab for COVID-19 Pre-Exposure Prophylaxis in Hematologic Patients\u2014A Tailored Approach Based on SARS-CoV-2 Vaccine Response"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4028-5357","authenticated-orcid":false,"given":"Krischan","family":"Braitsch","sequence":"first","affiliation":[{"name":"TUM School of Medicine and Health, Department of Internal Medicine III, University Medical Center, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1948-2057","authenticated-orcid":false,"given":"Samuel D.","family":"Jeske","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, Institute of Virology, University Medical Center, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Stroh","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, Department of Internal Medicine III, University Medical Center, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maike","family":"Hefter","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, Department of Internal Medicine III, University Medical Center, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Platen","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, Department of Nephrology, University Medical Center, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quirin","family":"Bachmann","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, Department of Nephrology, University Medical Center, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lutz","family":"Renders","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, Department of Nephrology, University Medical Center, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9421-1911","authenticated-orcid":false,"given":"Ulrike","family":"Protzer","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, Institute of Virology, University Medical Center, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6276-8002","authenticated-orcid":false,"given":"Katharina S.","family":"G\u00f6tze","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, Department of Internal Medicine III, University Medical Center, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Herhaus","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, Department of Internal Medicine III, University Medical Center, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mareike","family":"Verbeek","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, Department of Internal Medicine III, University Medical Center, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3875-5367","authenticated-orcid":false,"given":"Christoph D.","family":"Spinner","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, Department of Internal Medicine II, University Medical Center, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4435-2609","authenticated-orcid":false,"given":"Florian","family":"Bassermann","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, Department of Internal Medicine III, University Medical Center, Technical University of Munich, 81675 Munich, Germany"},{"name":"Center for Translational Cancer Research (TranslaTUM), Technical University of Munich, 81675 Munich, Germany"},{"name":"German Consortium for Translational Cancer Research (DKTK) Partner Site TUM, German Cancer Research Center Heidelberg (DKFZ), 69120 Heidelberg, Germany"},{"name":"Bavarian Cancer Research Center (BZKF), 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marion","family":"H\u00f6gner","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, Department of Internal Medicine III, University Medical Center, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9723-393X","authenticated-orcid":false,"given":"Bernhard","family":"Haller","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, Institute of AI and Informatics in Medicine, University Medical Center, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0300-0159","authenticated-orcid":false,"given":"Jochen","family":"Schneider","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, Department of Internal Medicine II, University Medical Center, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Heider","sequence":"additional","affiliation":[{"name":"TUM School of Medicine and Health, Department of Internal Medicine III, University Medical Center, Technical University of Munich, 81675 Munich, Germany"},{"name":"Center for Translational Cancer Research (TranslaTUM), Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1182\/blood.2021012251","article-title":"COVID-19 in patients with hematologic malignancy","volume":"140","author":"Langerbeins","year":"2022","journal-title":"Blood"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1982","DOI":"10.1158\/2159-8290.CD-21-0191","article-title":"Preexisting and Post-COVID-19 Immune Responses to SARS-CoV-2 in Patients with Cancer","volume":"11","author":"Bilich","year":"2021","journal-title":"Cancer Discov."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1111\/bjh.17704","article-title":"COVID-19 elicits an impaired antibody response against SARS-CoV-2 in patients with haematological malignancies","volume":"195","author":"Passamonti","year":"2021","journal-title":"Br. 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