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COVID-19 and Acute Leukemias: German Investigators Share Treatment Experiences

By: Joshua D. Madera, MS
Posted: Thursday, December 17, 2020

For patients with acute myeloid leukemia (AML) and acute lymphoblastic leukemia, the impact of concomitant infection with the coronavirus (SARS-CoV-2) remains elusive, according to a study published in Blood Advances. Currently, the recommended clinical course emphasizes the feasibility of low-intensive chemotherapy for these patients, according to Franziska Modemann, MD, of the University Medical Center of Hamburg, Eppendorf, and colleagues.

A total of 12 patients, 8 with AML and 4 with acute lymphoblastic leukemia (ALL) or lymphoblastic lymphoma (LBL), were included in the analysis. The profiles of patients with AML included untreated, newly diagnosed (n = 3), refractory or relapsed (n = 4), and complete remission with incomplete hematologic recovery (n = 1). Six patients received treatment with azacitidine and venetoclax following SARS-CoV-2 infection. The profiles of the others patients included untreated, Philadelphia chromosome B-cell AML (n = 1), T-cell ALL (n = 1), T-cell LBL (n = 1), and residual disease–positive B-cell ALL. All patients with ALL received treatment based on recommendations of the German Multicenter Study Group.

All patients with acute leukemias developed symptomatic SARS-CoV-2, which was confirmed with SARS-CoV-2 RNA via polymerase chain reaction. Of these patients, 10 were admitted to the intensive care unit, and 11 developed COVID-19 pneumonia. In addition, grade 4 neutropenia and grade 4 lymphopenia were identified in nine and six of these patients, respectively. Moreover, the four patients with refractory or relapsed AML did not develop acute respiratory distress syndrome. However, the three patients with untreated, newly diagnosed AML did present with acute respiratory distress syndrome.

Furthermore, CT analysis “showed bilateral, mainly peripheral, ground-glass opacities with (n = 4) or without (n = 2) consolidation, matching the typical finding of SARS-CoV-2 infection.”

Disclosure: For full disclosures of the study authors, visit ashpublications.org.



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