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Leukemia

Publication date: 2020-09-01
Volume: 34 Pages: 2354 - 2363
Publisher: Springer Nature [academic journals on nature.com]

Author:

Scarfo, Lydia
Chatzikonstantinou, Thomas ; Rigolin, Gian Matteo ; Quaresmini, Giulia ; Motta, Marina ; Vitale, Candida ; Antonio Garcia-Marco, Jose ; Angel Hernandez-Rivas, Jose ; Miras, Fatima ; Baile, Monica ; Marquet, Juan ; Niemann, Carsten U ; Reda, Gianluigi ; Munir, Talha ; Gimeno, Eva ; Marchetti, Monia ; Quaglia, Francesca Maria ; Varettoni, Marzia ; Delgado, Julio ; Iyengar, Sunil ; Janssens, Ann ; Marasca, Roberto ; Ferrari, Angela ; Cuellar-Garcia, Carolina ; Itchaki, Gilad ; Spacek, Martin ; De Paoli, Lorenzo ; Laurenti, Luca ; Levin, Mark-David ; Lista, Enrico ; Mauro, Francesca R ; Simkovic, Martin ; Van Der Spek, Ellen ; Vandenberghe, Elisabeth ; Trentin, Livio ; Wasik-Szczepanek, Ewa ; Ruchlemer, Rosa ; Bron, Dominique ; De Paolis, Maria Rosaria ; Del Poeta, Giovanni ; Farina, Lucia ; Foglietta, Myriam ; Gentile, Massimo ; Herishanu, Yair ; Herold, Tobias ; Jaksic, Ozren ; Kater, Arnon P ; Kersting, Sabina ; Malerba, Lara ; Orsucci, Lorella ; Popov, Viola Maria ; Sportoletti, Paolo ; Yassin, Mohamed ; Pocali, Barbara ; Barna, Gabor ; Chiarenza, Annalisa ; dos Santos, Gimena ; Nikitin, Eugene ; Andres, Martin ; Dimou, Maria ; Doubek, Michael ; Enrico, Alicia ; Hakobyan, Yervand ; Kalashnikova, Olga ; Ortiz Pareja, Macarena ; Papaioannou, Maria ; Rossi, Davide ; Shah, Nimish ; Shrestha, Amit ; Stanca, Oana ; Stavroyianni, Niki ; Strugov, Vladimir ; Tam, Constantine ; Zdrenghea, Mihnea ; Coscia, Marta ; Stamatopoulos, Kostas ; Rossi, Giuseppe ; Rambaldi, Alessandro ; Montserrat, Emili ; Foa, Robin ; Cuneo, Antonio ; Ghia, Paolo

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.