Haematologica (May 2022)

COVID-19 in adult acute myeloid leukemia patients: a long-term follow-up study from the European Hematology Association survey (EPICOVIDEHA)

  • Francesco Marchesi,
  • Jon Salmanton-García,
  • Ziad Emarah,
  • Klára Piukovics,
  • Marcio Nucci,
  • Alberto López-García,
  • Zdeněk Ráčil,
  • Francesca Farina,
  • Marina Popova,
  • Sofia Zompi,
  • Ernesta Audisio,
  • Marie-Pierre Ledoux,
  • Luisa Verga,
  • Barbora Weinbergerová,
  • Tomas Szotkovski,
  • Maria Gomes Da Silva,
  • Nicola Fracchiolla,
  • Nick De Jonge,
  • Graham Collins,
  • Monia Marchetti,
  • Gabriele Magliano,
  • Carolina García-Vidal,
  • Monika M. Biernat,
  • Jaap Van Doesum,
  • Marina Machado,
  • Fatih Demirkan,
  • Murtadha Al-Khabori,
  • Pavel Žák,
  • Benjamín Víšek,
  • Igor Stoma,
  • Gustavo-Adolfo Méndez,
  • Johan Maertens,
  • Nina Khanna,
  • Ildefonso Espigado,
  • Giulia Dragonetti,
  • Luana Fianchi,
  • Maria Ilaria Del Principe,
  • Alba Cabirta,
  • Irati Ormazabal-Vélez,
  • Ozren Jaksic,
  • Caterina Buquicchio,
  • Valentina Bonuomo,
  • Josip Batinić,
  • Ali S. Omrani,
  • Sylvain Lamure,
  • Olimpia Finizio,
  • Noemí Fernández,
  • Iker Falces-Romero,
  • Ola Blennow,
  • Rui Bergantim,
  • Natasha Ali,
  • Sein Win,
  • Jens Van Praet,
  • Maria Chiara Tisi,
  • Ayten Shirinova,
  • Martin Schönlein,
  • Juergen Prattes,
  • Monica Piedimonte,
  • Verena Petzer,
  • Milan Navrátil,
  • Austin Kulasekararaj,
  • Pavel Jindra,
  • Jiří Sramek,
  • Andreas Glenthøj,
  • Rita Fazzi,
  • Cristina De Ramón-Sánchez,
  • Chiara Cattaneo,
  • Maria Calbacho,
  • Nathan C. Bahr,
  • Shaimaa El-Ashwah,
  • Raul Cordoba,
  • Michaela Hanakova,
  • Giovanni Zambrotta,
  • Mariarita Sciumè,
  • Stephen Booth,
  • Raquel Nunes Rodrigues,
  • Maria Vittoria Sacchi,
  • Nicole García-Poutón,
  • Juan-Alberto Martín-González,
  • Sofya Khostelidi,
  • Stefanie Gräfe,
  • Laman Rahimli,
  • Emanuele Ammatuna,
  • Alessandro Busca,
  • Paolo Corradini,
  • Martin Hoenigl,
  • Nikolai Klimko,
  • Philipp Koehler,
  • Antonio Pagliuca,
  • Francesco Passamonti,
  • Oliver A. Cornely,
  • Livio Pagano

DOI
https://doi.org/10.3324/haematol.2022.280847
Journal volume & issue
Vol. 108, no. 1

Abstract

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Patients with acute myeloid leukemia (AML) are at high risk of dying from coronavirus disease 2019 (COVID-19). The optimal management of AML patients with COVID-19 has not been established. Our multicenter study included 388 adult AML patients diagnosed with COVID-19 between February 2020 and October 2021. The vast majority were receiving or had received AML treatment in the preceding 3 months. COVID-19 was severe in 41.2% and critical in 21.1% of cases. The chemotherapeutic schedule was modified in 174 patients (44.8%), delayed in 68 and permanently discontinued in 106. After a median follow-up of 325 days, 180 patients (46.4%) had died; death was attributed to COVID-19 (43.3%), AML (26.1%) or to a combination of both (26.7%), whereas in 3.9% of cases the reason was unknown. Active disease, older age, and treatment discontinuation were associated with death, whereas AML treatment delay was protective. Seventy-nine patients had a simultaneous AML and COVID-19 diagnosis, with better survival when AML treatment could be delayed (80%; P<0.001). Overall survival in patients with a diagnosis of COVID-19 between January 2020 and August 2020 was significantly lower than that in patients diagnosed between September 2020 and February 2021 and between March 2021 and September 2021 (39.8% vs. 60% vs. 61.9%, respectively; P=0.006). COVID-19 in AML patients was associated with a high mortality rate and modifications of therapeutic algorithms. The best approach to improve survival was to delay AML treatment, whenever possible.