SARS-CoV-2 infection in patients with chronic lymphocytic leukemia: The Italian Hematology Alliance on COVID-19 cohort.
BTK inhibitors
COVID-19
SARS-CoV-2
chronic lymphocytic leukemia
outcome
Journal
Hematological oncology
ISSN: 1099-1069
Titre abrégé: Hematol Oncol
Pays: England
ID NLM: 8307268
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
revised:
15
10
2022
received:
13
08
2022
accepted:
17
10
2022
pubmed:
21
10
2022
medline:
3
2
2023
entrez:
20
10
2022
Statut:
ppublish
Résumé
COVID-19, the disease caused by SARS-CoV-2, is still afflicting thousands of people across the globe. Few studies on COVID-19 in chronic lymphocytic leukemia (CLL) are available. Here, we analyzed data from the CLL cohort of the Italian Hematology Alliance on COVID-19 (NCT04352556), which included 256 CLL patients enrolled between 25 February 2020 and 1 February 2021. Median age was 70 years (range 38-94) with male preponderance (60.1%). Approximately half of patients (n = 127) had received at least one line of therapy for CLL, including 108 (83.7%) who were on active treatment at the time of COVID-19 or received their last therapy within 12 months. Most patients (230/256, 89.9%) were symptomatic at COVID-19 diagnosis and the majority required hospitalization (n = 176). Overall, after a median follow-up of 42 days (IQR 24-96), case fatality rate was 30.1%, and it was 37.5% and 24.4% in the first (25 February 2020-22 June 2020) and second wave (23 June 2020-1 February 2021), respectively (p = 0.03). At multivariate analysis, male sex (HR 1.82, 95% CI 1.03-3.24, p = 0.04), age over than 70 years (HR 2.23, 95% CI 1.23-4.05, p = 0.01), any treatment for CLL given in the last 12 months (HR 1.72, 95% CI 1.04-2.84, p = 0.04) and COVID-19 severity (severe: HR 5.66, 95% CI 2.62-12.33, p < 0.0001; critical: HR 15.99, 95% CI 6.93-36.90, p < 0.0001) were independently associated with poor survival. In summary, we report a dismal COVID-related outcome in a significant fraction of CLL patients, that can be nicely predicted by clinical parameters.
Identifiants
pubmed: 36265128
doi: 10.1002/hon.3092
pmc: PMC9874469
doi:
Types de publication
Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
128-138Subventions
Organisme : Associazione italiana contro le leucemie, linfomi e mieloma-Varese Onlus
Informations de copyright
© 2022 John Wiley & Sons Ltd.
Références
Coronavirus Disease (COVID-19) Situation. Accessed October 13, 2022. https://covid19.who.int/
Bhaskar S, Sinha A, Banach M, et al. Cytokine storm in COVID-19-immunopathological mechanisms, clinical considerations, and therapeutic approaches: the REPROGRAM consortium position paper. Front Immunol. 2020;11:1648. https://doi.org/10.3389/fimmu.2020.01648
Dai M, Liu D, Liu M, et al. Patients with cancer appear more vulnerable to SARS-CoV-2: a multicenter study during the COVID-19 outbreak. Cancer Discov. 2020;10(6):783-791. https://doi.org/10.1158/2159-8290.CD-20-0422
Forconi F, Moss P. Perturbation of the normal immune system in patients with CLL. Blood. 2015;126(5):573-581. https://doi.org/10.1182/blood-2015-03-567388
Mato AR, Roeker LE, Lamanna N, et al. Outcomes of COVID-19 in patients with CLL: a multicenter international experience. Blood. 2020;136(10):1134-1143. https://doi.org/10.1182/blood.2020006965
Roeker LE, Eyre TA, Thompson MC, et al. COVID-19 in patients with CLL: improved survival outcomes and update on management strategies. Blood. 2021;138(18):1768-1773. https://doi.org/10.1182/blood.2021011841
Scarfò L, Chatzikonstantinou T, Rigolin GM, et al. COVID-19 severity and mortality in patients with chronic lymphocytic leukemia: a joint study by ERIC, the European Research Initiative on CLL, and CLL Campus. Leukemia. 2020;34(9):2354-2363. https://doi.org/10.1038/s41375-020-0959-x
Chatzikonstantinou T, Kapetanakis A, Scarfò L, et al. COVID-19 severity and mortality in patients with CLL: an update of the international ERIC and Campus CLL study. Leukemia. 2021;35(12):3444-3454. https://doi.org/10.1038/s41375-021-01450-8
Maura F, Visco C, Falisi E, et al. B-cell receptor configuration and adverse cytogenetics are associated with autoimmune hemolytic anemia in chronic lymphocytic leukemia. Am J Hematol. 2013;88(1):32-36. https://doi.org/10.1002/ajh.23342
Crassini K, Stevenson WS, Mulligan SP, Best OG. Molecular pathogenesis of chronic lymphocytic leukaemia. Br J Haematol. 2019;186(5):668-684. https://doi.org/10.1111/bjh.16102
Passamonti F, Cattaneo C, Arcaini L, et al. Clinical characteristics and risk factors associated with COVID-19 severity in patients with haematological malignancies in Italy: a retrospective, multicentre, cohort study. Lancet Haematol. 2020;7(10):e737-e745. https://doi.org/10.1016/S2352-3026(20)30251-9
Hallek M, Cheson BD, Catovsky D, et al. Special report IwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL. Blood, J Am Soc Hematol. 2018:131(25), 2745-2760. https://doi.org/10.1182/blood-2017-09-806398
Cuneo A, Scarfò L, Reda G, et al. Chronic lymphocytic leukemia management in Italy during the COVID-19 pandemic: a Campus CLL report. Blood. 2020;136(6):763-766. https://doi.org/10.1182/blood.2020006854
Blixt L, Bogdanovic G, Buggert M, et al. Covid-19 in patients with chronic lymphocytic leukemia: clinical outcome and B- and T-cell immunity during 13 months in consecutive patients. Leukemia and Lymphoma. 2021:S136-S137. https://doi.org/10.1038/s41375-021-01424-w
Muntañola A, Villacampa G, Hernández-Rivas JÁ, et al. Clinical characteristics and outcome of SARS-CoV-2 infection in admitted patients with chronic lymphocytic leukemia from a single European country. Exp Hematol Oncol. 2020;9(1):4-7. https://doi.org/10.1186/s40164-020-00195-x
Vijenthira A, Gong IY, Fox TA, et al. Outcomes of patients with hematologic malignancies and COVID-19: a systematic review and meta-analysis of 3377 patients. Blood. 2020;136(25):2881-2892. https://doi.org/10.1182/blood.2020008824
Wood WA, Neuberg DS, Thompson JC, et al. Outcomes of patients with hematologic malignancies and COVID-19: a report from the ASH research collaborative data hub. Blood Adv. 2020;4(23):5966-5975. https://doi.org/10.1182/bloodadvances.2020003170
Pagano L, Salmanton-García J, Marchesi F, et al. COVID-19 infection in adult patients with hematological malignancies: a European Hematology Association Survey (EPICOVIDEHA). J Hematol Oncol. 2021;14(1):168. https://doi.org/10.1186/s13045-021-01177-0
Visco C, Marcheselli L, Mina R, et al. A prognostic model for patients with lymphoma and COVID-19: a multicentre cohort study. Blood Adv. 2022;6(1):327-338.
Chatzikonstantinou T, Herishanu Y, Montserrat E, et al. COVID-19 and chronic lymphocytic leukemia. Cancer J. 2021;27(4):328-333. https://doi.org/10.1097/ppo.0000000000000535
Visco C, Marcheselli L, Mina R, et al. A prognostic model for patients with lymphoma and COVID-19: a multicentre cohort study. Blood Adv. 2022;6(1):327-338. https://doi.org/10.1182/bloodadvances.2021005691
Treon SP, Castillo JJ, Skarbnik AP, et al. The BTK inhibitor ibrutinib may protect against pulmonary injury in COVID-19-infected patients. Blood. 2020;135(21):1912-1915. https://doi.org/10.1182/blood.2020006288
Cuneo A, Rigolin GM, Coscia M, et al. Management of chronic lymphocytic leukemia in Italy during a one year of the COVID-19 pandemic and at the start of the vaccination program. A Campus CLL report. Hematol Oncol. 2021;39(4):570-574. https://doi.org/10.1002/hon.2899
Drożdżal S, Rosik J, Lechowicz K, et al. An update on drugs with therapeutic potential for SARS-CoV-2 (COVID-19) treatment. Drug Resist Updat Rev Comment Antimicrob Anticancer Chemother. 2021;59:100794. https://doi.org/10.1016/j.drup.2021.100794
Buske C, Dreyling M, Alvarez-Larrán A, et al. Managing hematological cancer patients during the COVID-19 pandemic: an ESMO-EHA Interdisciplinary Expert Consensus. ESMO open. 2022;7(2):100403. https://doi.org/10.1016/j.esmoop.2022.100403
Levin MJ, Ustianowski A, De Wit S, et al. Intramuscular AZD7442 (Tixagevimab-Cilgavimab) for prevention of covid-19. N Engl J Med. 2022;386(23):2188-2200. https://doi.org/10.1056/NEJMoa2116620
Libster R, Pérez Marc G, Wappner D, et al. Early high-titer plasma therapy to prevent severe covid-19 in older adults. N Engl J Med. 2021;384(7):610-618. https://doi.org/10.1056/NEJMoa2033700
Kalil AC, Patterson TF, Mehta AK, et al. Baricitinib plus remdesivir for hospitalized adults with covid-19. N Engl J Med. 2021;384(9):795-807. https://doi.org/10.1056/NEJMoa2031994
Roeker LE, Knorr DA, Pessin MS, et al. Anti-SARS-CoV-2 antibody response in patients with chronic lymphocytic leukemia. Leukemia. 2020;34(11):3047-3049. https://doi.org/10.1038/s41375-020-01030-2
Passamonti F, Romano A, Salvini M, et al. COVID-19 elicits an impaired antibody response against SARS-CoV-2 in patients with haematological malignancies. Br J Haematol. 2021;195(3):371-377. https://doi.org/10.1111/bjh.17704
Herishanu Y, Rahav G, Levi S, et al. Efficacy of a third BNT162b2 mRNA COVID-19 vaccine dose in patients with CLL who failed standard two-dose vaccination. Blood. 2021;139(5):678-685. https://doi.org/10.1182/blood.2021014085
Haydu JE, Maron JS, Redd RA, et al. Humoral and cellular immunogenicity of SARS-CoV-2 vaccines in chronic lymphocytic leukemia: a prospective cohort study. Blood Adv. 2022;6(6):1671-1683. https://doi.org/10.1182/bloodadvances.2021006627
Gagelmann N, Passamonti F, Wolschke C, et al. Antibody response after vaccination against SARS-CoV-2 in adults with haematological malignancies: a systematic review and meta-analysis. Haematologica. 2021. https://doi.org/10.3324/haematol.2021.280163
Chang A, Akhtar A, Linderman SL, et al. Humoral responses against SARS-CoV-2 and variants of concern after mRNA vaccines in patients with non-hodgkin lymphoma and chronic lymphocytic leukemia. J Clin Oncol. 2022;2(26):1-13. https://doi.org/10.1200/jco.22.00088
Pagano L, Salmanton-García J, Marchesi F, et al. COVID-19 in vaccinated adult patients with hematological malignancies: preliminary results from EPICOVIDEHA. Blood. 2022;139(10):1588-1592. https://doi.org/10.1182/blood.2021014124
Mittelman M, Magen O, Barda N, et al. Effectiveness of the BNT162b2mRNA COVID-19 vaccine in patients with hematological neoplasms in a nationwide mass vaccination setting. Blood. 2022;139(10):1439-1451. https://doi.org/10.1182/blood.2021013768
Bronstein Y, Gat R, Levi S, et al. COVID-19 in patients with lymphoproliferative diseases during the Omicron variant surge. Cancer Cell. 2022;40(6):578-580. https://doi.org/10.1016/j.ccell.2022.04.015
Niemann CU, da Cunha-Bang C, Helleberg M, Ostrowski SR, Brieghel C. Patients with CLL have a lower risk of death from COVID-19 in the Omicron era. Blood. 2022;140(5):445-450. https://doi.org/10.1182/blood.2022016147