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.
| Original language | English |
|---|---|
| Pages (from-to) | 2354-2363 |
| Number of pages | 10 |
| Journal | Leukemia |
| Volume | 34 |
| Issue number | 9 |
| Early online date | 2020 |
| DOIs | |
| Publication status | Published - 1 Sept 2020 |
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In: Leukemia, Vol. 34, No. 9, 01.09.2020, p. 2354-2363.
Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - 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
AU - Scarfò, Lydia
AU - Chatzikonstantinou, Thomas
AU - Rigolin, Gian Matteo
AU - Quaresmini, Giulia
AU - Motta, Marina
AU - Vitale, Candida
AU - Garcia-Marco, Jose Antonio
AU - Hernández-Rivas, José Ángel
AU - Mirás, Fatima
AU - Baile, M. nica
AU - Marquet, Juan
AU - Niemann, Carsten U.
AU - Reda, Gianluigi
AU - Munir, Talha
AU - Gimeno, Eva
AU - Marchetti, Monia
AU - Quaglia, Francesca Maria
AU - Varettoni, Marzia
AU - Delgado, Julio
AU - Iyengar, Sunil
AU - Janssens, Ann
AU - Marasca, Roberto
AU - Ferrari, Angela
AU - Cuéllar-García, Carolina
AU - Itchaki, Gilad
AU - Špaček, Martin
AU - de Paoli, Lorenzo
AU - Laurenti, Luca
AU - Levin, Mark-David
AU - Lista, Enrico
AU - Mauro, Francesca R.
AU - Šimkovič, Martin
AU - van der Spek, Ellen
AU - Vandenberghe, Elisabeth
AU - Trentin, Livio
AU - Wasik-Szczepanek, Ewa
AU - Ruchlemer, Rosa
AU - Bron, Dominique
AU - de Paolis, Maria Rosaria
AU - del Poeta, Giovanni
AU - Farina, Lucia
AU - Foglietta, Myriam
AU - Gentile, Massimo
AU - Herishanu, Yair
AU - Herold, Tobias
AU - Jaksic, Ozren
AU - Kater, Arnon P.
AU - Kersting, Sabina
AU - Malerba, Lara
AU - Orsucci, Lorella
AU - Popov, Viola Maria
AU - Sportoletti, Paolo
AU - Yassin, Mohamed
AU - Pocali, Barbara
AU - Barna, Gabor
AU - Chiarenza, Annalisa
AU - dos Santos, Gimena
AU - Nikitin, Eugene
AU - Andres, Martin
AU - Dimou, Maria
AU - Doubek, Michael
AU - Enrico, Alicia
AU - Hakobyan, Yervand
AU - Kalashnikova, Olga
AU - Ortiz Pareja, Macarena
AU - Papaioannou, Maria
AU - Rossi, Davide
AU - Shah, Nimish
AU - Shrestha, Amit
AU - Stanca, Oana
AU - Stavroyianni, Niki
AU - Strugov, Vladimir
AU - Tam, Constantine
AU - Zdrenghea, Mihnea
AU - Coscia, Marta
AU - Stamatopoulos, Kostas
AU - Rossi, Giuseppe
AU - Rambaldi, Alessandro
AU - Montserrat, Emili’
AU - Foà, Robin
AU - Cuneo, Antonio
AU - Ghia, Paolo
N1 - Funding Information: CUN received research support and/or honoraria from Abbvie, AstraZeneca, CSL Behring, Janssen, and Sunesis. GR received honoraria from AbbVie, Gilead, Janssen. EG received travel grants, honoraria as consultant and/or speaker bureau from Janssen, Abbvie, Roche, and Gilead. MoMo received consultant fees from Gilead. MV received honoraria for Advisory boards from Janssen and Roche. SI received Honoraria Janssen and Gilead. AJ received travel grants, speaker fees or consultancies: Amgen, Abbvie, Celgene, Janssen, Gilead, Novartis, Sanofi-Genzyme, Roche. AF received honoraria from AbbVie. MaSp received honoraria from AbbVie, Gilead, and Janssen. ML received honoraria for Advisory board and travel compensation from Janssen, Abbvie, and Roche. EVDS received compensation for teaching activities from Amgen. EV received travel grants from Abbvie, Gilead, Jannsenns, and Roche, research grants from Abbvie, Gilead, and Roche. LF received honoraria from AbbVie, Janssen (Advisory role or Lecturer). MF received honoraria from Abbvie, Janssen, Gilead. YH received honoraria from AbbVie, AstraZeneca, Janssen, Medison, Sanofi, and Roche. OJ received Honoraria from Abbvie, Janssen, and Roche. APK received research support: Abbvie, Janssen, Roche/Genentech, AstraZeneca; Adboard: Abbvie, Janssen, Roche/Genentech, AstraZeneca; speakersfee: Jans-sen, AstraZeneca, Abbvie. SK received Travel grant from Celgene, research funding from Janssen, Abbvie. MA received travel support and advisory boards from AbbVie, Janssen-Cilag, Celgene, Novartis. DR received honoraria from Abbvie, AstraZeneca, Gilead, Janssen, Loxo, and Verastem, and research grants from Abbvie, AstraZeneca, Cellestia, Gilead, Janssen. NS received consulting fees from AbbVie, Roche, Janssen. CT received honorarium and research funding from Janssen, Beigene, and Abbvie. MC received research funding from Janssen and Karyopharm Therapeutics, and personal fees from Jans-sen, Gilead, Abbvie, and Shire, outside the submitted work. KS received honoraria from Abbvie, Acerta/AstraZeneca, Gilead, Janssen, and research funding from Abbvie, Gilead, Janssen. AC received honoraria from AbbVie, AstraZeneca, Gilead, Janssen. RF received honoraria from Abbvie, Gliead, Janssen, AstraZeneca, Amgen, Incyte, Novartis. PG received honoraria from AbbVie, Adaptive, Acerta/ AstraZeneca, ArQule, BioGene, Dynamo, Gilead, Janssen, MEI, Sunesis, and Research funding from AbbVie, Gilead, Janssen, Sunesis. TC, GQ, FM, MB, JM, TM, FMQ, JD, RM, CC, GI, LDP, LL, EL, FRM, MaSi, LT, EW, RR, DB, MRDP, GDP, MG, TH, LM, LO VMP, PS, MY, BP, GB, AC, GdS, EN, MaDi, MiDo, AE, YH, OK, MOP, MP, AS, OA, NS, VS, MZ, GR, AR, EM have no conflict of interest to disclose. Funding Information: Conflict of interest LS received honoraria from AbbVie, AstraZeneca, Gilead, Janssen. GMR received honoraria from Abbvie, Gliead, and Janssen and research funding from Gilead. MaMo received onoraria from Janssen and Roche. CV received consultancy fees from Janssen, outside the submitted work. JAG received honoraria from AbbVie, AstraZeneca, Gilead, Janssen, and Roche. Research funding from AbbVie, Gilead, and Janssen. JAH received honoraria for lectures and Advisory Boards from Janssen, Abbvie, Roche, Gilead, AstraZeneca. Funding Information: Acknowledgements This work was in part supported by Associazione Italiana per la Ricerca sul Cancro—AIRC, Milano, Italy (Investigator Grant #20246 and Special Program on Metastatic Disease—5 per mille #21198); ERA NET TRANSCAN-2 Joint Transnational Call for Proposals: JTC 2014 (project #143 GCH-CLL) and JTC 2016 (project #179 NOVEL), project code (MIS) 5041673; Bando della Ricerca Finalizzata 2018, Ministero della Salute, Roma, Italy (pro-getto RF-2018-12368231); the SARS-CoV-2 research mission of the Greek Secretariat for Research and Technology; BEAT Leukemia and AIL-FE. Publisher Copyright: © 2020, The Author(s), under exclusive licence to Springer Nature Limited. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85087678355&partnerID=8YFLogxK
U2 - https://doi.org/10.1038/s41375-020-0959-x
DO - https://doi.org/10.1038/s41375-020-0959-x
M3 - Article
C2 - 32647324
SN - 0887-6924
VL - 34
SP - 2354
EP - 2363
JO - Leukemia
JF - Leukemia
IS - 9
ER -