Frontiers in Oncology (Oct 2022)

B-cell malignancies treated with targeted drugs and SARS-CoV-2 infection: A European Hematology Association Survey (EPICOVIDEHA)

  • Maria Stefania Infante,
  • Jon Salmanton-García,
  • Jon Salmanton-García,
  • Ana Fernández-Cruz,
  • Francesco Marchesi,
  • Ozren Jaksic,
  • Barbora Weinbergerová,
  • Caroline Besson,
  • Rafael F. Duarte,
  • Federico Itri,
  • Toni Valković,
  • Toni Valković,
  • Toni Valković,
  • Tomáš Szotkovski,
  • Alessandro Busca,
  • Anna Guidetti,
  • Andreas Glenthøj,
  • Graham P. Collins,
  • Valentina Bonuomo,
  • Uluhan Sili,
  • Guldane Cengiz Seval,
  • Marina Machado,
  • Raul Cordoba,
  • Ola Blennow,
  • Ghaith Abu-Zeinah,
  • Sylvain Lamure,
  • Austin Kulasekararaj,
  • Austin Kulasekararaj,
  • Iker Falces-Romero,
  • Chiara Cattaneo,
  • Jaap Van Doesum,
  • Klára Piukovics,
  • Ali S. Omrani,
  • Gabriele Magliano,
  • Marie-Pierre Ledoux,
  • Cristina de Ramon,
  • Cristina de Ramon,
  • Alba Cabirta,
  • Alba Cabirta,
  • Alba Cabirta,
  • Luisa Verga,
  • Luisa Verga,
  • Alberto López-García,
  • Maria Gomes Da Silva,
  • Zlate Stojanoski,
  • Stef Meers,
  • Tobias Lahmer,
  • Sonia Martín-Pérez,
  • Julio Dávila-Vals,
  • Jens Van Praet,
  • Michail Samarkos,
  • Yavuz M. Bilgin,
  • Linda Katharina Karlsson,
  • Josip Batinić,
  • Anna Nordlander,
  • Martin Schönlein,
  • Martin Hoenigl,
  • Martin Hoenigl,
  • Martin Hoenigl,
  • Zdeněk Ráčil,
  • Miloš Mladenović,
  • Michaela Hanakova,
  • Giovanni Paolo Maria Zambrotta,
  • Giovanni Paolo Maria Zambrotta,
  • Nick De Jonge,
  • Tatjana Adžić-Vukičević,
  • Raquel Nunes-Rodrigues,
  • Lucia Prezioso,
  • Milan Navrátil,
  • Monia Marchetti,
  • Annarosa Cuccaro,
  • Maria Calbacho,
  • Antonio Giordano,
  • Antonio Giordano,
  • Oliver A. Cornely,
  • Oliver A. Cornely,
  • Oliver A. Cornely,
  • Oliver A. Cornely,
  • Oliver A. Cornely,
  • José-Ángel Hernández-Rivas,
  • Livio Pagano

DOI
https://doi.org/10.3389/fonc.2022.992137
Journal volume & issue
Vol. 12

Abstract

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Patients with lymphoproliferative diseases (LPD) are vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Here, we describe and analyze the outcome of 366 adult patients with chronic lymphocytic leukemia (CLL) or non-Hodgkin Lymphoma (NHL) treated with targeted drugs and laboratory-confirmed COVID-19 diagnosed between February 2020 and January 2022. Median follow-up was 70.5 days (IQR 0-609). Most used targeted drugs were Bruton-kinase inhibitors (BKIs) (N= 201, 55%), anti-CD20 other than rituximab (N=61, 16%), BCL2 inhibitors (N=33, 9%) and lenalidomide (N=28, 8%).Only 16.2% of the patients were vaccinated with 2 or more doses of vaccine at the onset of COVID-19. Mortality was 24% (89/366) on day 30 and 36%(134/366) on the last day of follow-up. Age >75 years (p<0.001, HR 1.036), active malignancy (p<0.001, HR 2.215), severe COVID-19 (p=0.017, HR 2.270) and admission to ICU (p<0.001, HR 5.751) were risk factors for mortality at last day of follow up. There was no difference in OS rates in NHL vs CLL patients (p=0.306), nor in patients treated with or without BKIs (p=0.151). Mortality in ICU was 66% (CLL 61%, NHL 76%). Overall mortality rate decreased according to vaccination status, being 39% in unvaccinated patients, 32% and 26% in those having received one or two doses, respectively, and 20% in patients with a booster dose (p=0.245). Overall mortality rate dropped from 41% during the first semester of 2020 to 25% at the last semester of 2021. These results show increased severity and mortality from COVID-19 in LPDs patients treated with targeted drugs.

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