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

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

doi:10.3324/haematol.2022.280847

Cited by 30 publications

(42 citation statements)

References 26 publications

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“…Interestingly, Marchesi et al showed that a treatment delay was protective in a multivariate analysis for the clinical course of COVID-19, whereas therapy discontinuation was associated with worse outcomes. These results were also applicable to patients with newly diagnosed AML in whom a treatment delay was possible [ 31 ]. The Latin American study investigating 83 patients with AL reported therapy modifications in 49% of patients; the main modification was a delay of treatment, followed by a change in therapy scheme and a dose reduction (no data available about discontinuation).…”

Section: Impact Of Covid-19 On Al Treatmentmentioning

confidence: 96%

“…Overall, across all COVID-19 waves, the SARS-CoV-2-associated mortality ranged from 20–52% in patients with AL [ 31 , 32 , 33 ]. However, no comprehensive data are yet available for the Omicron variant.…”

Section: Clinical Coursesmentioning

confidence: 99%

“…One of the largest multi-center trials investigating the impact of COVID-19 in adult AML patients was recently published by the European Hematology Association [ 31 ]. The EPICOVIDEHA registry included 388 adult AML patients with a COVID-19 diagnosis between February 2020 and October 2021.…”

Section: Clinical Coursesmentioning

confidence: 99%

“…Ongoing or recent AML treatment (defined as less than three months before SARS-CoV-2 infection) was associated with higher mortality rates due to COVID-19, as well as active leukemic disease, older age, and treatment discontinuation. Significantly lower overall survival was observed in patients diagnosed between January 2020 and August 2020 (first wave), compared to those after September 2020 (41% vs. 25%, p < 0.0001) [ 31 ]. This is the only more extensive data set that allows a comparison between the different SARS-CoV-2 waves.…”

Section: Clinical Coursesmentioning

confidence: 99%

“…In the most recently published cohort of 388 adult AML patients, chemotherapeutic schedules were modified in 45% of patients. Of those, therapy was delayed in 39% and treatment was discontinued in 61% [ 31 ]. Interestingly, Marchesi et al showed that a treatment delay was protective in a multivariate analysis for the clinical course of COVID-19, whereas therapy discontinuation was associated with worse outcomes.…”

Section: Impact Of Covid-19 On Al Treatmentmentioning

confidence: 99%

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COVID-19 and Adult Acute Leukemia: Our Knowledge in Progress

Modemann

Ghandili

Schmiedel

et al. 2022

Cancers

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The majority of publications regarding SARS-CoV-2 infections in adult patients with acute leukemia (AL) refer to hematological patients in general and are not focused on acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL). We herein report a review of the current literature on adult AL patients infected with SARS-CoV-2. Overall, SARS-CoV-2-associated mortality ranges from 20–52% in patients with adult AL. AML patients have a particularly high COVID-19-related mortality. Of note, most of the available data relate to the pre-vaccination era and to variants before Omicron. The impact of COVID-19 infections on AL treatment is rarely reported. Based on the few studies available, treatment delay does not appear to be associated with an increased risk of relapse, whereas therapy discontinuation was associated with worse outcomes in AML patients. Therefore, the current recommendations suggest delaying systemic AL treatment in SARS-CoV-2-positive patients until SARS-CoV-2 negativity, if immediate AL treatment is not required. It is recommended to offer vaccination to all AL patients; the reported antibody responses are around 80–96%. Seronegative patients should additionally receive prophylactic administration of anti-SARS-CoV-2 monoclonal antibodies. Patients with AL infected with SARS-CoV-2 should be treated early with antiviral therapy to prevent disease progression and enable the rapid elimination of the virus.

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Section: Impact Of Covid-19 On Al Treatmentmentioning

confidence: 96%

Section: Clinical Coursesmentioning

confidence: 99%

Section: Clinical Coursesmentioning

confidence: 99%

Section: Clinical Coursesmentioning

confidence: 99%

Section: Impact Of Covid-19 On Al Treatmentmentioning

confidence: 99%

See 3 more Smart Citations

COVID-19 and Adult Acute Leukemia: Our Knowledge in Progress

Modemann

Ghandili

Schmiedel

et al. 2022

Cancers

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Respiratory Viruses in Patients With Hematological Malignancy in Boreal Autumn/Winter 2023–2024: EPICOVIDEHA‐EPIFLUEHA Report

Salmanton‐García,

Marchesi,

Navrátil

et al. 2024

American J Hematol

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Community‐acquired respiratory viral infections (CARV) significantly impact patients with hematological malignancies (HM), leading to high morbidity and mortality. However, large‐scale, real‐world data on CARV in these patients is limited. This study analyzed data from the EPICOVIDEHA‐EPIFLUEHA registry, focusing on patients with HM diagnosed with CARV during the 2023–2024 autumn–winter season. The study assessed epidemiology, clinical characteristics, risk factors, and outcomes. The study examined 1312 patients with HM diagnosed with CARV during the 2023–2024 autumn–winter season. Of these, 59.5% required hospitalization, with 13.5% needing ICU admission. The overall mortality rate was 10.6%, varying by virus: parainfluenza (21.3%), influenza (8.8%), metapneumovirus (7.1%), RSV (5.9%), or SARS‐CoV‐2 (5.0%). Poor outcomes were significantly associated with smoking history, severe lymphopenia, secondary bacterial infections, and ICU admission. This study highlights the severe risk CARV poses to patients with HM, especially those undergoing active treatment. The high rates of hospitalization and mortality stress the need for better prevention, early diagnosis, and targeted therapies. Given the severe outcomes with certain viruses like parainfluenza, tailored strategies are crucial to improving patient outcomes in future CARV seasons.

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Managing and treating COVID-19 in patients with hematological malignancies: a narrative review and expert insights

Ng,

Alata,

Nguyen

et al. 2024

Clin Exp Med

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Patients with hematologic malignancies (HMs) are at a significantly higher risk of contracting COVID-19 and experiencing severe outcomes compared to individuals without HMs. This heightened risk is influenced by various factors, including the underlying malignancy, immunosuppressive treatments, and patient-related factors. Notably, immunosuppressive regimens commonly used for HM treatment can lead to the depletion of B cells and T cells, which is associated with increased COVID-19-related complications and mortality in these patients. As the pandemic transitions into an endemic state, it remains crucial to acknowledge and address the ongoing risk for individuals with HMs. In this review, we aim to summarize the current evidence to enhance our understanding of the impact of HMs on COVID-19 risks and outcomes, identify particularly vulnerable individuals, and emphasize the need for specialized clinical attention and management. Furthermore, the impaired immune response to COVID-19 vaccination observed in these patients underscores the importance of implementing additional mitigation strategies. This may include targeted prophylaxis and treatment with antivirals and monoclonal antibodies as indicated. To provide practical guidance and considerations, we present two illustrative cases to highlight the real-life challenges faced by physicians caring for patients with HMs, emphasizing the need for individualized management based on disease severity, type, and the unique circumstances of each patient.

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

Cited by 30 publications

References 26 publications

COVID-19 and Adult Acute Leukemia: Our Knowledge in Progress

COVID-19 and Adult Acute Leukemia: Our Knowledge in Progress

Respiratory Viruses in Patients With Hematological Malignancy in Boreal Autumn/Winter 2023–2024: EPICOVIDEHA‐EPIFLUEHA Report

Managing and treating COVID-19 in patients with hematological malignancies: a narrative review and expert insights

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