Since its first identification in China in December 2019, several reports have been published describing epidemiological and clinical characteristics of patients with COVID-19, with an overall mortality rate ranging from 1.4% to 2.3%, that can increase up to 22.4%-24.5% in hospitalized patients. 2,3 Patients with cancer have a higher susceptibility to infections due to their immunosuppression state caused by the malignancy itself or by antineoplastic treatments. Specifically, infections caused by community respiratory viruses had been associated with poor outcome in patients with hematological malignancies. Few data are available on hematologic patients and COVID-19 infection, with discordant results, probably due to the small sample size of the studies. To date, these data come from retrospective clinical case series 4-9 from different countries in which case fatality rates (CFR) range from 33% to 62%. Mortality has been associated, depending on the published series, with age, comorbidities, active hematological disease, intensive treatment, or some laboratory variables. Thus, more data are required to better characterize the real impact of COVID-19 in patients with hematological neoplasms, in order to optimize clinical decision-making. We carried out a single-center analysis of 41 consecutive patients with hematological malignancies who developed COVID-19 between March 8 and

In recent years, new prognostic indexes (PIs) for chronic lymphocytic leukemia (CLL), which include clinical, biological, and genetic variables, have been validated, highlighting the MD Anderson Cancer Center prognostic index (MDACC PI), the CLL-international prognostic index (CLL-IPI), and the Barcelona-Brno biomarkers only prognostic model. The aim of this study is to compare the utility of these PIs in a cohort of Spanish patients. A retrospective analysis of 696 unselected CLL patients newly diagnosed and previously untreated from different Spanish institutions was performed. The MDACC PI, the CLL-IPI, and the biomarkers only PI were applied to these patients, and a comparison of the three PIs was performed. With a median follow-up time of 46 months, 394 patients were alive and 187 had received treatment. The median overall survival (OS) was 173 months and the median time to first therapy (TTFT) was 32 months. Significant differences were obtained in OS and TTFT for all subgroups when applying these PIs, with the CLL-IPI being the one with the higher c-index (0.676 for OS and 0.757 for TTFT). The three PIs were able to discriminate patients in different prognostic subgroups. In our cohort, the CLL-IPI showed higher power in predicting TTFT and OS.

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Chronic lymphocytic leukemia (CLL) is an extremely heterogeneous disease. With the advent of oral targeted agents (Tas) the treatment of CLL has undergone a revolution, which has been accompanied by an improvement in patient’s survival and quality of life. This paradigm shift also affects the value of prognostic and predictive biomarkers and prognostic models, most of them inherited from the chemoimmunotherapy era but with a different behavior with Tas. This review discusses: (i) the role of the most relevant prognostic and predictive biomarkers in the setting of Tas; and (ii) the validity of classic and new scoring systems in the context of Tas. In addition, a critical point of view about predictive biomarkers with special emphasis on 11q deletion, novel resistance mutations, TP53 abnormalities, IGHV mutational status, complex karyotype and NOTCH1 mutations is stated. We also go over prognostic models in early stage CLL such as IPS-E. Finally, we provide an overview of the applicability of the CLL-IPI for patients treated with Tas, as well as the emergence of new models, generated with data from patients treated with Tas.