COVID-19 and Leukemias: Focus on Risk Factors for Poor Outcomes
Posted: Wednesday, August 4, 2021
For patients with acute myeloid leukemia (AML) who contract COVID-19, there is a high mortality rate, especially among patients with active disease and neutropenia. The results from a small cohort of patients in New York City were published in Leukemia & Lymphoma by Aaron D. Goldberg, MD, PhD, of Weill Cornell Medical College in New York, New York, and his colleagues.
Researchers conducted a retrospective cohort study of 65 patients with AML, acute lymphoid leukemia (ALL), chronic myeloid leukemia (CML), chronic lymphoblastic leukemia (CLL), myelodysplastic syndromes (MDS), and myelodysplastic neoplasm (MPN) who were infected with COVID-19 between March and May 2020. Clinical outcomes for patients were monitored until July 2020. Most patients in this cohort had either CLL (38%) or AML (22%). About half (52%) of patients had received treatment within the 3 months prior to being diagnosed with COVID-19. There were 14 patients (22%) with neutropenia at the time of COVID-19 diagnosis as well. Within this group, 40% of patients received care for COVID-19 in the outpatient setting and 60%, in the inpatient setting.
Regarding treatment of COVID-19 in this cohort, 32% received hydroxychloroquine, 25% received azithromycin, 19% received convalescent plasma, 8% received tocilizumab, and 5% received remdesivir. A total of 2 patients required high-flow nasal cannula therapy, and 12 patients were intubated for mechanical ventilation. There were 11 deaths (17%) attributed to COVID-19–related complications, and the median time from COVID-19 diagnosis to death was 12 days.
Patients with AML were more likely to die of COVID-19 than non-AML patients (odds ratio = 4.7), and 35% of patients with AML died of COVID-19–related complications. In comparison, 29% of those with MPN, 17% of those with ALL, 8% of those with CLL, and none of the patients with MDS or CML died of COVID-19. Among the six patients with AML who died of COVID-19, poor outcomes seemed to be driven by neutropenia, thrombocytopenia, active treatment in the past 3 months, and patients older than 60.
Disclosure: For a full list of authors’ disclosures, visit www.tandfonline.com.