Original Articles
Vol. 14 No. 1 (2022): Review Articles, Original Article, Scientific Letter, Case Reports Letter to the Editor
IMPACT OF COVID-19 ON OUTCOMES OF PATIENTS WITH HEMATOLOGIC MALIGNANCIES: A MULTI-CENTER, RETROSPECTIVE STUDY
COVID-19 and hematologic malignancy
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Received: May 24, 2022
Accepted: September 17, 2022
Accepted: September 17, 2022
1152
Views
602
Downloads
179
HTML
Authors
Objectives: Patients with hematologic malignancies have a high risk of coronavirus disease 2019 (COVID-19) mortality. This study aimed to investigate the impact of COVID-19 on mortality rates in patients with various hematologic malignancies and to determine risk factors associated with all-cause mortality.
Methods: A multi-center, observational retrospective analysis of patients with hematologic malignancies infected with COVID-19 between July 2020 and December 2021 was performed. Demographic data, clinical characteristics, and laboratory parameters were recorded. Patients were grouped as non-survivors and survivors. All-cause mortality was the primary outcome of the study.
Results: There were 569 patients with a median age of 59 years. Non-Hodgkin lymphoma (22.0%) and multiple myelomas (18.1%) were the two most frequent hematologic malignancies. The all-cause mortality rate was 29.3%. The highest mortality rates were seen in patients with acute myeloid leukemia (44.3%), acute lymphoid leukemia (40.5%), and non-Hodgkin lymphoma (36.8%). The non-survivors were significantly older (p<0.001) and had more comorbidities (p<0.05). There were significantly more patients with low lymphocyte percentage (p<0.001), thrombocytopenia (p<0.001), and high CRP (p<0.001) in the non-survived patients. Cardiac comorbidities, (p=0.016), cytotoxic chemotherapy (p=0.024), low lymphocyte percentage (p=0.025), thrombocytopenia (p<0.0001), and high CRP values (p=0.017) were the independent risk factors for the prediction of mortality.
Conclusions: In patients with hematologic malignancies, coexistent COVID-19 leads to a higher mortality rate in elderly patients with more comorbidities. Acute myeloid and lymphoid leukemia and non-Hodgkin lymphoma have the highest mortality rates. Cardiac diseases, cytotoxic chemotherapy, lymphopenia, thrombocytopenia, and high CRP are the independent risk factors for mortality in hematologic malignancy patients with COVID-19.
Keywords: Covid; Hematologic Malignancy; Cytotoxic chemotherapy.
Downloads
Download data is not yet available.
Citations
Visco C, Marcheselli L, Mina R, Sassone M, Guidetti A, Penna D, Cattaneo C, Bonuomo V, Busca A, Ferreri AJM, Bruna R, Petrucci L, Cairoli R, Salvini M, Bertù L, Ladetto M, Pilerci S, Pinto A, Ramadan S, Marchesi F, Cavo M, Arcaini L, Coviello E, Romano A, Musto P, Massaia M, Fracchiolla N, Marchetti M, Scattolin A, Tisi MC, Cuneo A, Della Porta M, Trentin L, Turrini M, Gherlinzoni F, Tafuri A, Galimberti S, Bocchia M, Cardinali V, Cilloni D, Corso A, Armiento D, Rigacci L, La Barbera EO, Gambacorti-Passerini C, Visani G, Vallisa D, Venditti A, Selleri C, Conconi A, Tosi P, Lanza F, Candoni A, Krampera M, Corradini P, Passamonti F, Merli F; ITA-HEMA-COV investigators. A prognostic model for patients with lymphoma and COVID-19: a multicentre cohort study. Blood Adv. 2022;6(1):327-338.
doi: 10.1182/bloodadvances.2021005691.
PMID: 34644385;
Papakonstantinou E, Dragoumani K, Efthimiadou A, Palaiogeorgou AM, Pierouli K, Mitsis T, Chrousos GP, Bacopoulou F, Vlachakis D. Haematological malignancies implications during the times of the COVID-19 pandemic. Oncol Lett. 2021;22(6):856. doi: 10.3892/ol.2021.13117.
PMID: 34777590;
Tıglıoglu P, Albayrak M, Tıglıoğlu M, Ozturk HBA, Aras MR, Saglam B, Maral S. The outcome of COVID-19 in patients with hematological malignancy. Memo. 2022;15(1):83-89.
doi: 10.1007/s12254-021-00775-5.
PMID: 34904019
Pagano L, Salmanton-García J, Marchesi F, Busca A, Corradini P, Hoenigl M, Klimko N, Koehler P, Pagliuca A, Passamonti F, Verga L, Víšek B, Ilhan O, Nadali G, Weinbergerová B, Córdoba-Mascuñano R, Marchetti M, Collins GP, Farina F, Cattaneo C, Cabirta A, Gomes-Silva M, Itri F, van Doesum J, Ledoux MP, Čerňan M, Jakšić O, Duarte RF, Magliano G, Omrani AS, Fracchiolla NS, Kulasekararaj A, Valković T, Poulsen CB, Machado M, Glenthøj A, Stoma I, Ráčil Z, Piukovics K, Navrátil M, Emarah Z, Sili U, Maertens J, Blennow O, Bergantim R, García-Vidal C, Prezioso L, Guidetti A, Del Principe MI, Popova M, de Jonge N, Ormazabal-Vélez I, Fernández N, Falces-Romero I, Cuccaro A, Meers S, Buquicchio C, Antić D, Al-Khabori M, García-Sanz R, Biernat MM, Tisi MC, Sal E, Rahimli L, Čolović N, Schönlein M, Calbacho M, Tascini C, Miranda-Castillo C, Khanna N, Méndez GA, Petzer V, Novák J, Besson C, Duléry R, Lamure S, Nucci M, Zambrotta G, Žák P, Seval GC, Bonuomo V, Mayer J, López-García A, Sacchi MV, Booth S, Ciceri F, Oberti M, Salvini M, Izuzquiza M, Nunes-Rodrigues R, Ammatuna E, Obr A, Herbrecht R, Núñez-Martín-Buitrago L, Mancini V, Shwaylia H, Sciumè M, Essame J, Nygaard M, Batinić J, Gonzaga Y, Regalado-Artamendi I, Karlsson LK, Shapetska M, Hanakova M, El-Ashwah S, Borbényi Z, Çolak GM, Nordlander A, Dragonetti G, Maraglino AME, Rinaldi A, De Ramón-Sánchez C, Cornely OA; EPICOVIDEHA working group. COVID-19 infection in adult patients with hematological malignancies: a European Hematology Association Survey (EPICOVIDEHA). J Hematol Oncol. 2021;14(1):168.
doi: 10.1186/s13045-021-01177-0.
PMID: 34649563
Jain A, Nayak L, Kulkarni UP, Mehra N, Yanamandra U, Kayal S, Damodar S, John JM, Mehta P, Singh S, Munot P, Selvarajan S, Radhakrishnan V, Lad D, Kapoor R, Dubashi B, Bharath RS, Jain H, Jayachandran PK, Lakshmanan J, Mani T, Thorat J, Das S, Karunamurthy O, George B, Sengar M, Malhotra P. Outcomes of patients with hematologic malignancies and COVID-19 from the Hematologic Cancer Registry of India. Blood Cancer J. 2022;12(1):2. doi: 10.1038/s41408-021-00599-w. PMID: 34987161
Giacomelli A, Ridolfo AL, Milazzo L, Oreni L, Bernacchia D, Siano M, Bonazzetti C, Covizzi A, Schiuma M, Passerini M, Piscaglia M, Coen M, Gubertini G, Rizzardini G, Cogliati C, Brambilla AM, Colombo R, Castelli A, Rech R, Riva A, Torre A, Meroni L, Rusconi S, Antinori S, Galli M. 30-day mortality in patients hospitalized with COVID-19 during the first wave of the Italian epidemic: A prospective cohort study. Pharmacol Res. 2020;158:104931.
doi: 10.1016/j.phrs.2020.104931.
PMID: 32446978
Pinato DJ, Zambelli A, Aguilar-Company J, Bower M, Sng C, Salazar R, Bertuzzi A, Brunet J, Mesia R, Segui E, Biello F, Generali D, Grisanti S, Rizzo G, Libertini M, Maconi A, Harbeck N, Vincenzi B, Bertulli R, Ottaviani D, Carbo A, Bruna R, Benafif S, Marrari A, Wuerstlein R, Carmona-Garcia MC, Chopra N, Tondini C, Mirallas O, Tovazzi V, Betti M, Provenzano S, Fotia V, Cruz CA, Dalla Pria A, D'Avanzo F, Evans JS, Saoudi-Gonzalez N, Felip E, Galazi M, Garcia-Fructuoso I, Lee AJX, Newsom-Davis T, Patriarca A, Garcia-Illescas D, Reyes R, Dileo P, Sharkey R, Wong YNS, Ferrante D, Marco-Hernandez J, Sureda A, Maluquer C, Ruiz-Camps I, Gaidano G, Rimassa L, Chiudinelli L, Izuzquiza M, Cabirta A, Franchi M, Santoro A, Prat A, Tabernero J, Gennari A. Clinical portrait of the SARS-CoV-2 epidemic in European cancer patients. Cancer Discov. 2020 Jul 31;10(10):1465–74.
doi: 10.1158/2159-8290.CD-20-0773.
PMID: 32737082
Khan MMA, Khan MN, Mustagir MG, Rana J, Islam MS, Kabir MI. Effects of underlying morbidities on the occurrence of deaths in COVID-19 patients: A systematic review and meta-analysis. J Glob Health. 2020;10(2):020503.
doi: 10.7189/jogh.10.020503.
PMID: 33110586
Vijenthira A, Gong IY, Fox TA, Booth S, Cook G, Fattizzo B, Martín-Moro F, Razanamahery J, Riches JC, Zwicker J, Patell R, Vekemans MC, Scarfò L, Chatzikonstantinou T, Yildiz H, Lattenist R, Mantzaris I, Wood WA, Hicks LK. Outcomes of patients with hematologic malignancies and COVID-19: a systematic review and meta-analysis of 3377 patients. Blood. 2020 Dec 17;136(25):2881-2892.
doi: 10.1182/blood.2020008824.
PMID: 33113551
Lee LYW, Cazier JB, Starkey T, Briggs SEW, Arnold R, Bisht V, Booth S, Campton NA, Cheng VWT, Collins G, Curley HM, Earwaker P, Fittall MW, Gennatas S, Goel A, Hartley S, Hughes DJ, Kerr D, Lee AJX, Lee RJ, Lee SM, Mckenzie H, Middleton CP, Murugaesu N, Newsom-Davis T, Olsson-Brown AC, Palles C, Powles T, Protheroe EA, Purshouse K, Sharma-Oates A, Sivakumar S, Smith AJ, Topping O, Turnbull CD, Várnai C, Briggs ADM, Middleton G, Kerr R; UK Coronavirus Cancer Monitoring Project Team. COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort study. Lancet Oncol. 2020;21(10):1309-1316. Erratum in: Lancet Oncol. 2020.
doi: 10.1016/S1470-2045(20)30442-3.
PMID: 32853557
Pagnano KB, Peralta EH, Navarro JR, David Salas LDR, Delgado N, Moiraghi B, Toreli ACM, Perobelli LM, Fechio L, Quixada ATS, Funke V, Bendit I, Seguro FS, Pilleux L, Bortolini J, Lourenço ALG, Sapelli J, Nucci FM, Pavlovsky C, Oliveira LDC, Moura MS, Palma LC, Gonçalves NN, Conchon M, Hokama POM, Almeida LL, Zulli R, de Souza CA, Boquimpani CM. COVID-19 in chronic myeloid leukemia patients in Latin America. Leuk Lymphoma. 2021;62(13):3212-3218.
doi: 10.1080/10428194.2021.1950709.
PMID: 34254886.
Scarfò L, Chatzikonstantinou T, Rigolin GM, Quaresmini G, Motta M, Vitale C, Garcia-Marco JA, Hernández-Rivas JÁ, Mirás F, Baile M, Marquet J, Niemann CU, Reda G, Munir T, Gimeno E, Marchetti M, Quaglia FM, Varettoni M, Delgado J, Iyengar S, Janssens A, Marasca R, Ferrari A, Cuéllar-García C, Itchaki G, Špaček M, De Paoli L, Laurenti L, Levin MD, Lista E, Mauro FR, Šimkovič M, Van Der Spek E, Vandenberghe E, Trentin L, Wasik-Szczepanek E, Ruchlemer R, Bron D, De Paolis MR, Del Poeta G, Farina L, Foglietta M, Gentile M, Herishanu Y, Herold T, Jaksic O, Kater AP, Kersting S, Malerba L, Orsucci L, Popov VM, Sportoletti P, Yassin M, Pocali B, Barna G, Chiarenza A, Dos Santos G, Nikitin E, Andres M, Dimou M, Doubek M, Enrico A, Hakobyan Y, Kalashnikova O, Ortiz Pareja M, Papaioannou M, Rossi D, Shah N, Shrestha A, Stanca O, Stavroyianni N, Strugov V, Tam C, Zdrenghea M, Coscia M, Stamatopoulos K, Rossi G, Rambaldi A, Montserrat E, Foà R, Cuneo A, Ghia P. COVID-19 severity and mortality in patients with chronic lymphocytic leukemia: a joint study by ERIC, the European Research Initiative on CLL, and CLL Campus. Leukemia. 2020;34(9):2354-2363.
doi: 10.1038/s41375-020-0959-x.
PMID: 32647324
Booth S, Curley HM, Varnai C, Arnold R, Lee LYW, Campton NA, Cook G, Purshouse K, Aries J, Innes A, Cook LB, Tomkins O, Oram HS, Tilby M, Kulasekararaj A, Wrench D, Dolly S, Newsom-Davies T, Pettengell R, Gault A, Moody S, Mittal S, Altohami M, Tillet T, Illingworth J, Mukherjee L, Apperly J, Ashcroft J, Rabin N, Carmichael J, Cazier JB, Kerr R, Middleton G, Collins GP, Palles C; UKCCMP team. Key findings from the UKCCMP cohort of 877 patients with haematological malignancy and COVID-19: disease control as an important factor relative to recent chemotherapy or anti-CD20 therapy. Br J Haematol. 2022;196(4):892-901.
doi: 10.1111/bjh.17937.
PMID: 34761389
World Health Organization. WHO Interim Guidance. Clinical Management of COVID-19. Geneva, WHO, 2020. https://apps.who.int/iris/handle/10665/332196
Kitahara CM, Flint AJ, Berrington de Gonzalez A, Bernstein L, Brotzman M, MacInnis RJ, Moore SC, Robien K, Rosenberg PS, Singh PN, Weiderpass E, Adami HO, Anton-Culver H, Ballard-Barbash R, Buring JE, Freedman DM, Fraser GE, Beane Freeman LE, Gapstur SM, Gaziano JM, Giles GG, Håkansson N, Hoppin JA, Hu FB, Koenig K, Linet MS, Park Y, Patel AV, Purdue MP, Schairer C, Sesso HD, Visvanathan K, White E, Wolk A, Zeleniuch-Jacquotte A, Hartge P. Association between class III obesity (BMI of 40-59 kg/m2) and mortality: a pooled analysis of 20 prospective studies. PLoS Med. 2014;11(7):e1001673.
doi: 10.1371/journal.pmed.1001673.
PMID: 25003901
Romano A, Cerchione C, Conticello C, Filetti S, Bulla A, Chiarenza A, Del Fabro V, Leotta S, Markovic U, Motta G, Parisi M, Stagno F, Palumbo GA, Di Raimondo F. Reduced Absolute Count of Monocytes in Patients Carrying Hematological Neoplasms and SARS-CoV2 Infection. Cancers (Basel). 2022;14(5):1173.
doi: 10.3390/cancers14051173.
PMID: 35267478
García-Suárez J, de la Cruz J, Cedillo Á, Llamas P, Duarte R, Jiménez-Yuste V, Hernández-Rivas JÁ, Gil-Manso R, Kwon M, Sánchez-Godoy P, Martínez-Barranco P, Colás-Lahuerta B, Herrera P, Benito-Parra L, Alegre A, Velasco A, Matilla A, Aláez-Usón MC, Martos-Martínez R, Martínez-Chamorro C, Susana-Quiroz K, Del Campo JF, de la Fuente A, Herráez R, Pascual A, Gómez E, Pérez-Oteyza J, Ruiz E, Alonso A, González-Medina J, Martín-Buitrago LN, Canales M, González-Gascón I, Vicente-Ayuso MC, Valenciano S, Roa MG, Monteliu PE, López-Jiménez J, Escobar CE, Ortiz-Martín J, Diez-Martin JL, Martinez-Lopez J; Asociación Madrileña de Hematología y Hemoterapia (AMHH). Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry study. J Hematol Oncol. 2020;13(1):133.
doi: 10.1186/s13045-020-00970-7.
PMID: 33032660
Borah P, Mirgh S, Sharma SK, Bansal S, Dixit A, Dolai TK, Lunkad S, Gupta N, Singh G, Jain A, Bansal D, Choudhary D, Khandelwal V, Doval D, Kumar M, Bhargava R, Chakrabarti A, Kalashetty M, Rauthan A, Kazi B, Mandal PK, Jeyaraman P, Naithani R; AIIMS Hematology Alumni Group. Effect of age, comorbidity and remission status on outcome of COVID-19 in patients with hematological malignancies. Blood Cells Mol Dis. 2021;87:102525. doi: 10.1016/j.bcmd.2020.102525. PMID: 33338697
Yigenoglu TN, Ata N, Altuntas F, Bascı S, Dal MS, Korkmaz S, Namdaroglu S, Basturk A, Hacıbekiroglu T, Dogu MH, Berber İ, Dal K, Erkurt MA, Turgut B, Ulgu MM, Celik O, Imrat E, Birinci S. The outcome of COVID-19 in patients with hematological malignancy. J Med Virol. 2021;93(2):1099-1104.
doi: 10.1002/jmv.26404.
PMID: 32776581
Regalado-Artamendi I, Jiménez-Ubieto A, Hernández-Rivas JÁ, Navarro B, Núñez L, Alaez C, Córdoba R, Peñalver FJ, Cannata J, Estival P, Quiroz-Cervantes K, Riaza Grau R, Velasco A, Martos R, Domingo-González A, Benito-Parra L, Gómez-Sanz E, López-Jiménez J, Matilla A, Herraez MR, Penalva MJ, García-Suárez J, Díez-Martín JL, Bastos-Oreiro M. Risk Factors and Mortality of COVID-19 in Patients With Lymphoma: A Multicenter Study. Hemasphere. 2021;5(3):e538.
doi: 10.1097/HS9.0000000000000538.
PMID: 33604516
Wood WA, Neuberg DS, Thompson JC, Tallman MS, Sekeres MA, Sehn LH, Anderson KC, Goldberg AD, Pennell NA, Niemeyer CM, Tucker E, Hewitt K, Plovnick RM, Hicks LK. Outcomes of patients with hematologic malignancies and COVID-19: a report from the ASH Research Collaborative Data Hub. Blood Adv. 2020;4(23):5966-5975.
doi: 10.1182/bloodadvances.2020003170.
PMID: 33278301
Modemann F, Niederwieser C, Weisel K, Bokemeyer C, Fiedler W, Ghandili S. COVID-19 and seasonal influenza: a comparative analysis in patients with hematological malignancies. Leuk Lymphoma. 2022;63(3):664-671.
doi: 10.1080/10428194.2021.1992626.
PMID: 34668809.
Piñana JL, Martino R, García-García I, Parody R, Morales MD, Benzo G, Gómez-Catalan I, Coll R, De La Fuente I, Luna A, Merchán B, Chinea A, de Miguel D, Serrano A, Pérez C, Diaz C, Lopez JL, Saez AJ, Bailen R, Zudaire T, Martínez D, Jurado M, Calbacho M, Vázquez L, Garcia-Cadenas I, Fox L, Pimentel AI, Bautista G, Nieto A, Fernandez P, Vallejo JC, Solano C, Valero M, Espigado I, Saldaña R, Sisinni L, Ribera JM, Jimenez MJ, Trabazo M, Gonzalez-Vicent M, Fernández N, Talarn C, Montoya MC, Cedillo A, Sureda A; Infectious Complications Subcommittee of the Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH). Risk factors and outcome of COVID-19 in patients with hematological malignancies. Exp Hematol Oncol. 2020;9:21.
doi: 10.1186/s40164-020-00177-z.
PMID: 32864192
Civriz Bozdağ S, Cengiz Seval G, Yönal Hindilerden İ, Hindilerden F, Andıç N, Baydar M, Aydın Kaynar L, Toprak SK, Göksoy HS, Balık Aydın B, Demirci U, Can F, Özkocaman V, Gündüz E, Güven ZT, Özkurt ZN, Demircioğlu S, Beksaç M, İnce İ, Yılmaz U, Eroğlu Küçükdiler H, Abishov E, Yavuz B, Ataş Ü, Mutlu YG, Baş V, Özkalemkaş F, Üsküdar Teke H, Gürsoy V, Çelik S, Çiftçiler R, Yağcı M, Topçuoğlu P, Çeneli Ö, Abbasov H, Selim C, Ar MC, Yücel OK, Sadri S, Albayrak C, Demir AM, Güler N, Keklik M, Terzi H, Doğan A, Yegin ZA, Kurt Yüksel M, Sadri S, Yavaşoğlu İ, Beköz HS, Aksu T, Maral S, Erol V, Kaynar L, İlhan O, Bolaman AZ, Sevindik ÖG, Akyay A, Özcan M, Gürman G, Ünal Ş, Yavuz Y, Diz Küçükkaya R, Özsan GH. Clinical Characteristics and Outcomes of COVID-19 in Turkish Patients with Hematological Malignancies. Turk J Haematol. 2022;39(1):43-54.
doi: 10.4274/tjh.galenos.2021.2021.0287.
PMID: 34521187
How to Cite
“IMPACT OF COVID-19 ON OUTCOMES OF PATIENTS WITH HEMATOLOGIC MALIGNANCIES: A MULTI-CENTER, RETROSPECTIVE STUDY: COVID-19 and hematologic malignancy” (2022) Mediterranean Journal of Hematology and Infectious Diseases, 14(1), p. e2022074. doi:10.4084/MJHID.2022.074.
Copyright (c) 2022 İbrahim Halil Açar, Sebnem Izmir Güner , Muzeyyen Aslaner Ak, Mesut Gocer, Erman Ozturk , Figen Atalay, Gulden Sincan , Aysun Senturk Yikilmaz, Omer Ekinci, Idris Ince, Emine Gulturk , Nazli Demir, Ali Dogan, Yildiz Ipek, Birol Guvenc
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
