Outcomes of COVID-19 in patients with CLL: A multicenter international experience Journal Article

Authors: Mato, A. R.; Roeker, L. E.; Lamanna, N.; Allan, J. N.; Leslie, L.; Pagel, J. M.; Patel, K.; Osterborg, A.; Wojenski, D.; Kamdar, M.; Huntington, S. F.; Davids, M. S.; Brown, J. R.; Antic, D.; Jacobs, R.; Ahn, I. E.; Pu, J.; Isaac, K. M.; Barr, P. M.; Ujjani, C. S.; Geyer, M. B.; Berman, E.; Zelenetz, A. D.; Malakhov, N.; Furman, R. R.; Koropsak, M.; Bailey, N.; Hanson, L.; Perini, G. F.; Ma, S.; Ryan, C. E.; Wiestner, A.; Portell, C. A.; Shadman, M.; Chong, E. A.; Brander, D. M.; Sundaram, S.; Seddon, A. N.; Seymour, E.; Patel, M.; Martinez-Calle, N.; Munir, T.; Walewska, R.; Broom, A.; Walter, H.; El-Sharkawi, D.; Parry, H.; Wilson, M. R.; Patten, P. E. M.; Hernández-Rivas, J. A.; Miras, F.; Escalada, N. F.; Ghione, P.; Nabhan, C.; Lebowitz, S.; Bhavsar, E.; López-Jiménez, J.; Naya, D.; Garcia-Marco, J. A.; Skånland, S. S.; Cordoba, R.; Eyre, T. A.
Article Title: Outcomes of COVID-19 in patients with CLL: A multicenter international experience
Abstract: Given advanced age, comorbidities, and immune dysfunction, chronic lymphocytic leukemia (CLL) patients may be at particularly high risk of infection and poor outcomes related to coronavirus disease 2019 (COVID-19). Robust analysis of outcomes for CLL patients, particularly examining effects of baseline characteristics and CLL-directed therapy, is critical to optimally manage CLL patients through this evolving pandemic. CLL patients diagnosed with symptomatic COVID-19 across 43 international centers (n = 198) were included. Hospital admission occurred in 90%. Median age at COVI D-19 diagnosis was 70.5 years. Median Cumulative Illness Rating Scale score was 8 (range, 4-32). Thirty-nine percent were treatment naive ("watch and wait"), while 61% had received >= 1 CLL-directed therapy (median, 2; range, 1-8). Ninety patients (45%) were receiving active CLL therapy at COVID-19 diagnosis, most commonly Bruton tyrosine kinase inhibitors (BTKi's; n = 68/90 [76%]). At a median follow-up of 16 days, the overall case fatality rate was 33%, though 25% remain admitted. Watch-and-wait and treated cohorts had similar rates of admission (89% vs 90%), intensive care unit admission (35% vs 36%), intubation (33% vs 25%), and mortality (37% vs 32%). CLL-directed treatment with BTKi's at COVID-19 diagnosis did not impact survival (case fatality rate, 34% vs 35%), though the BTKi was held during the COVID-19 course for most patients. These data suggest that the subgroup of CLL patients admitted with COVID-19, regardless of disease phase or treatment status, are at high risk of death. Future epidemiologic studies are needed to assess severe acute respiratory syndrome coronavirus 2 infection risk, these data should be validated independently, and randomized studies of BTKi's in COVID-19 are needed to provide definitive evidence of benefit.
Keywords: cancer
Journal Title: Blood
Volume: 136
Issue: 10
ISSN: 0006-4971
Publisher: American Society of Hematology  
Date Published: 2020-09-03
Start Page: 1134
End Page: 1143
Language: English
ACCESSION: WOS:000571446600007
DOI: 10.1182/blood.2020006965
PMCID: PMC7472711
PUBMED: 32688395
Notes: Article -- Source: Wos
Citation Impact
MSK Authors
  1. Andrew D Zelenetz
    693 Zelenetz
  2. Ellin Berman
    158 Berman
  3. Mark Blaine Geyer
    60 Geyer
  4. Anthony R Mato
    188 Mato
  5. Lindsey Elizabeth Roeker
    78 Roeker
  6. Paola Ghione
    30 Ghione