Background Data on patients with COVID-19 who have cancer are lacking. Here we characterise the outcomes of a cohort of patients with cancer and COVID-19 and identify potential prognostic factors for mortality and severe illness.Methods In this cohort study, we collected de-identified data on patients with active or previous malignancy, aged 18 years and older, with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection from the USA, Canada, and Spain from the COVID-19 and Cancer Consortium (CCC19) database for whom baseline data were added between March 17 and April 16, 2020. We collected data on baseline clinical conditions, medications, cancer diagnosis and treatment, and COVID-19 disease course. The primary endpoint was all-cause mortality within 30 days of diagnosis of COVID-19. We assessed the association between the outcome and potential prognostic variables using logistic regression analyses, partially adjusted for age, sex, smoking status, and obesity. This study is registered with ClinicalTrials.gov, NCT04354701, and is ongoing. FindingsOf 1035 records entered into the CCC19 database during the study period, 928 patients met inclusion criteria for our analysis. Median age was 66 years (IQR 57-76), 279 (30%) were aged 75 years or older, and 468 (50%) patients were male. The most prevalent malignancies were breast (191 [21%]) and prostate (152 [16%]). 366 (39%) patients were on active anticancer treatment, and 396 (43%) had active (measurable) cancer. At analysis (May 7, 2020), 121 (13%) patients had died. In logistic regression analysis, independent factors associated with increased 30-day mortality, after partial adjustment, were: increased age (per 10 years; partially adjusted odds ratio 1•84, 95% CI 1•53-2•21), male sex (1•63, 1•07-2•48), smoking status (former smoker vs never smoked: 1•60, 1•03-2•47), number of comorbidities (two vs none: 4•50, 1•33-15•28), Eastern Cooperative Oncology Group performance status of 2 or higher (status of 2 vs 0 or 1: 3•89, 2•11-7•18), active cancer (progressing vs remission: 5•20, 2•77-9•77), and receipt of azithromycin plus hydroxychloroquine (vs treatment with neither: 2•93, 1•79-4•79; confounding by indication cannot be excluded). Compared with residence in the US-Northeast, residence in Canada (0•24, 0•07-0•84) or the US-Midwest (0•50, 0•28-0•90) were associated with decreased 30-day all-cause mortality. Race and ethnicity, obesity status, cancer type, type of anticancer therapy, and recent surgery were not associated with mortality. Interpretation Among patients with cancer and COVID-19, 30-day all-cause mortality was high and associated with general risk factors and risk factors unique to patients with cancer. Longer follow-up is needed to better understand the effect of COVID-19 on outcomes in patients with cancer, including the ability to continue specific cancer treatments.

IMPORTANCE COVID-19 is a life-threatening illness for many patients. Prior studies have established hematologic cancers as a risk factor associated with particularly poor outcomes from COVID-19. To our knowledge, no studies have established a beneficial role for anti-COVID-19 interventions in this at-risk population. Convalescent plasma therapy may benefit immunocompromised individuals with COVID-19, including those with hematologic cancers.OBJECTIVE To evaluate the association of convalescent plasma treatment with 30-day mortality in hospitalized adults with hematologic cancers and COVID-19 from a multi-institutional cohort. DESIGN, SETTING, AND PARTICIPANTSThis retrospective cohort study using data from the COVID-19 and Cancer Consortium registry with propensity score matching evaluated patients with hematologic cancers who were hospitalized for COVID-19. Data were collected between

The classic Philadelphia chromosome–negative myeloproliferative neoplasms (MPN) consist of myelofibrosis, polycythemia vera, and essential thrombocythemia and are a heterogeneous group of clonal blood disorders characterized by an overproduction of blood cells. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for MPN were developed as a result of meetings convened by a multidisciplinary panel with expertise in MPN, with the goal of providing recommendations for the management of MPN in adults. The Guidelines include recommendations for the diagnostic workup, risk stratification, treatment, and supportive care strategies for the management of myelofibrosis, polycythemia vera, and essential thrombocythemia. Assessment of symptoms at baseline and monitoring of symptom status during the course of treatment is recommended for all patients. This article focuses on the recommendations as outlined in the NCCN Guidelines for the diagnosis of MPN and the risk stratification, management, and supportive care relevant to MF.

Aggressive lymphoma arising in the setting of underlying chronic lymphocytic leukemia (CLL), known as Richter syndrome (RS), is associated with poor outcomes with current standard-of-care therapies, 1 particularly among patients with clonally related disease, prior ibrutinib treatment, and complex karyotype (CK). 1,2 In our institutional experience, the median overall survival following RS diagnosis was only 5.9 months, with ,40% of patients achieving an objective response to anthracycline-based chemoimmunotherapy. 2 Two anti-CD19 chimeric antigen receptor (CAR) T-cell (CAR-T) therapies, axicabtagene ciloleucel (axi-cel) and tisagenlecleucel, are approved by the US Food and Drug Administration (FDA) for relapsed/refractory diffuse large B-cell lymphoma (DLBCL) or high-grade B-cell lymphoma. Both provide durable disease control in roughly 50% of patients, including cases of chemorefractory disease. 3,4 Although anti-CD19 CART therapy was first studied in CLL and achieves an antitumor response in some cases, response rates in CLL are lower compared with DLBCL, which may be explained by CLL-induced impairment in T-cell fitness and persistence. 5,6 Owing in part to concerns related to CLL-induced immune dysfunction, patients with RS were excluded from the pivotal trials of axi-cel and tisagenlecleucel in DLBCL, 3,4 and literature regarding the efficacy of approved CART products in patients with RS is lacking. Herein, we describe the experience of our institution of treating patients with RS with commercial axi-cel. After obtaining institutional review board approval, we identified 9 patients treated at our center for RS with axi-cel between 1 January 2019 and 15 May 2020. Baseline patient and disease characteristics along with subsequent clinical course were obtained from the electronic medical record by review of progress notes, pathology reports, and imaging studies. Cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) were graded and reported using American Society for Transplantation and Cellular Therapy (ASTCT) Consensus Grading as standard practice at our center 7 and responses were assessed according to the 2014 Lugano Classification. 8 The timing of response evaluation was in accordance with institutional practice: computed tomography (CT) imaging was performed ;30 days and positron emission tomography imaging ;90 days after axi-cel infusion. Commercial axi-cel was administered off-label. Baseline patient characteristics (Table 1) included a median age of 64 years (range, 40-77 years) and a median of 4 (2-6) prior lines of therapy for CLL and/or RS. Eight patients had prior acalabrutinib or ibrutinib treatment: of these 8 patients who had received Bruton tyrosine kinase inhibitor (BTKi), 5 also received prior venetoclax, 1 patient had prior programmed cell death protein 1 inhibitor therapy, and 1 patient had previously received anti-CD19 CART therapy in an investigational trial for CLL. Five patients were previously treated with anthracycline-based chemoimmunother...