Chronic lymphocytic leukemia management in Italy during the COVID-19 pandemic: a Campus CLL report

Cuneo, Antonio; Scarfò, Lydia; Reda, Gianluigi; Varettoni, Marzia; Quaglia, Francesca Maria; Marchetti, Monia; Paoli, Lorenzo De; Pietrasanta, Daniela; Rigolin, Gian Matteo; Orsucci, Lorella; Ibatici, Adalberto; Gattei, Valter; Mauro, Francesca Romana; Trentin, Livio; Laurenti, Luca; Marasca, Roberto; Foà, Robin

doi:10.1182/blood.2020006854

Cited by 34 publications

(49 citation statements)

References 6 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Considering the median age of 72 years at the time of COVID-19 occurrence and the presence of at least one comorbidity in~75% of our patients (median number of comorbidities 2), the high mortality rate (55/169, 32.5%) among the hospitalized patients reported in this cohort comes as no surprise, though it is apparently higher than expected in the general population (e.g., 13.4% amongst the general population in Italy) (https://www.epicentro.iss.it/ coronavirus/). However, if we consider only patients with CLL ≥ 70 years of age, the percentage (36/105, 34.3%) is not considerably different from that of normal individuals >70 years (25.5%, https://www.epicentro.iss.it/coronavirus/) [18]. The difference in the overall mortality rate was seen in all age groups, with young patients (<65 years) succumbing to the disease at rates similar to those of the elderly (26.2% and 31.0%, respectively), though the elderly patients were more likely to experience severe COVID-19, as reported above.…”

Section: Discussionmentioning

confidence: 95%

“…Data extracted from the medical records included: baseline demographics, date of CLL diagnosis, CLL treatment status, presence, number, and type of comorbidities, date of COVID-19, COVID-19 symptoms, COVID-19 management, treatment, and outcome. Of the 190 patients studied, four Spanish cases were previously published in extenso [12], 47 patients were included in a report describing the impact of SARS-CoV-2 pandemic infection on the practical management of CLL in Italy with only limited clinical data [18].…”

Section: Data Collectionmentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2020

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 95%

Section: Data Collectionmentioning

confidence: 99%

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

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…In this study, we analyzed the prevalence of COVID-19 in patients with hematologic diseases receiving active and/or supportive treatment. The only data reported in the literature to date on the epidemiology of the CO-VID-19 in large hematologic populations of patients are represented by 3 Italian surveys which showed a prevalence of 0.4% (1 of 267 patients) in adult Ph+ acute lymphoblastic leukemia patients, 0.5% (47 of 9,339 patient) in chronic lymphocytic leukemia patients, and 0.17% (12 of 6,883 patients) in chronic myeloid leukemia patients, and a Chinese study from the Hubei province on 530 subjects with chronic myeloid leukemia which reported a prevalence of 0.9% that was 9-fold higher than normal but much lower than the prevalence in hospitalized patients with other cancers or normal healthcare providers [10][11][12][13]. No information is available on childhood hematologic cancer populations.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is striking that this population appears to be poorly represented in the comorbidities reported for patients with COVID-19. Indeed, epidemiologic data specifically regarding hematologic patients are limited [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 in Patients with Hematologic Disorders Undergoing Therapy: Perspective of a Large Referral Hematology Center in Rome

et al. 2020

Self Cite

View full text Add to dashboard Cite

Introduction: Patients with cancer may be more susceptible to and have higher morbidity and mortality rates from COVID-19 than the general population, while epidemiologic data specifically addressed to hematologic patients are limited. To investigate whether patients with hematologic diseases undergoing therapy are at increased risk for acquiring SARS CoV-2 infection compared to the general population, a retrospective study was carried out at a referral hematologic center in Rome, Italy, during the period of the greatest epidemic spread (March 8 to May 14, 2020). Methods: All adult and pediatric patients with a diagnosis of a neoplastic or a nonneoplastic hematologic disease who underwent treatment (chemotherapy or immunosuppressive or supportive therapy) during the study period or in the previous 6 months were considered. The prevalence of COVID-19 in the overall outpatient and inpatient population undergoing hematologic treatment compared to that of the general population was analyzed. The measures taken to manage patients during the epidemic period are described. Results: Overall, 2,513 patients with hematological diseases were considered. Out of 243 (9.7%) patients who were screened for SARS CoV-2, three of 119 (2.5%) outpatients with fever or respiratory symptoms and none of 124 asymptomatic patients were diagnosed with COVID-19. Three further patients were diagnosed with COVID-19 and managed in other hospitals in Rome. As of May 14, 2020, the prevalence of COVID-19 in our hematologic population accounted for 0.24% (95% CI 0.23–0.25; 6 of 2,513 patients: 1 case in every 419 patients) as compared to 0.12% (7,280 of 5,879,082 residents; 1 case in every 807 residents) in the general population (p = 0.14). Three of 6 patients diagnosed with COVID-19 required critical care and 2 died while still positive for SARS CoV-2. Out of 225 healthcare providers on duty at our Institution during the study period, 2 (0.9%) symptomatic cases were diagnosed with COVID-19. Conclusion: In our experience, the prevalence of COVID-19 in hematologic patients, mainly affected by malignancies, was not significantly higher compared to that of the general population. Definition of adapted strategies for healthcare services, while continuing to administer the standard hematologic treatments, represents the crucial challenge for the management of hematologic diseases in the COVID-19 era.

show abstract

“…Spain has been one the most affected countries by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19) pandemic [1,2]. Patients with chronic lymphocytic leukemia (CLL) could be at risk of more severe COVID-19 clinical forms [3] since they often carry immune perturbations aggravated by treatments used for the disease itself [4]. Two major series on patients with COVID-19 and CLL encompassing different countries and health systems reported heterogeneous factors related to the outcome [5,6].…”

Section: Letter To the Editormentioning

confidence: 99%

Clinical characteristics and outcome of SARS-CoV-2 infection in admitted patients with chronic lymphocytic leukemia from a single European country

et al. 2020

View full text Add to dashboard Cite

Chronic lymphocytic leukemia management in Italy during the COVID-19 pandemic: a Campus CLL report

Cited by 34 publications

References 6 publications

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

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

COVID-19 in Patients with Hematologic Disorders Undergoing Therapy: Perspective of a Large Referral Hematology Center in Rome

Clinical characteristics and outcome of SARS-CoV-2 infection in admitted patients with chronic lymphocytic leukemia from a single European country

Contact Info

Product

Resources

About