Leukemia
Author:
Keywords:
Science & Technology, Life Sciences & Biomedicine, Oncology, Hematology, CLINICAL CHARACTERISTICS, RISK-FACTORS, MULTICENTER, CANCER, CHINA, Adenine, Age Factors, Aged, Aged, 80 and over, Antineoplastic Agents, Betacoronavirus, COVID-19, Comorbidity, Coronavirus Infections, Female, Humans, Leukemia, Lymphocytic, Chronic, B-Cell, Male, Middle Aged, Pandemics, Piperidines, Pneumonia, Viral, Prognosis, Protein Kinase Inhibitors, Pyrazoles, Pyrimidines, Retrospective Studies, SARS-CoV-2, Severity of Illness Index, Surveys and Questionnaires, 1103 Clinical Sciences, 1112 Oncology and Carcinogenesis, Immunology, 3201 Cardiovascular medicine and haematology, 3202 Clinical sciences, 3211 Oncology and carcinogenesis
Abstract:
Chronic lymphocytic leukemia (CLL) is a disease of the elderly, characterized by immunodeficiency. Hence, patients with CLL might be considered more susceptible to severe complications from COVID-19. We undertook this retrospective international multicenter study to characterize the course of COVID-19 in patients with CLL and identify potential predictors of outcome. Of 190 patients with CLL and confirmed COVID-19 diagnosed between 28/03/2020 and 22/05/2020, 151 (79%) presented with severe COVID-19 (need of oxygen and/or intensive care admission). Severe COVID-19 was associated with more advanced age (≥65 years) (odds ratio 3.72 [95% CI 1.79-7.71]). Only 60 patients (39.7%) with severe COVID-19 were receiving or had recent (≤12 months) treatment for CLL at the time of COVID-19 versus 30/39 (76.9%) patients with mild disease. Hospitalization rate for severe COVID-19 was lower (p < 0.05) for patients on ibrutinib versus those on other regimens or off treatment. Of 151 patients with severe disease, 55 (36.4%) succumbed versus only 1/38 (2.6%) with mild disease; age and comorbidities did not impact on mortality. In CLL, (1) COVID-19 severity increases with age; (2) antileukemic treatment (particularly BTK inhibitors) appears to exert a protective effect; (3) age and comorbidities did not impact on mortality, alluding to a relevant role of CLL and immunodeficiency.