Preview

Oncohematology

Advanced search

COVID-19 in patients with acute leukemia: 3 years' experience of pandemic

https://doi.org/10.17650/1818-8346-2023-18-4(Suppl)-45-52

Abstract

Patients with acute leukemia are one of the most vulnerable risk groups for infection with SARS-CoV-2 and severe course of coronavirus infection. During the first 2 years of the pandemic, the mortality rate of patients with acute leukemia was 11-48 %, depending on leukemia type, and only reached population levels in 2022. Risk factors for severe COVID-19 in patients with acute leukemia are old age, concomitant cardiac pathology, metabolic syndrome, and the absence of acute leukemia remission. Chemotherapy administered one month before hospitalization with COVID-19 diagnosis showed statistical significance in influencing hospital mortality only in the group of patients with acute myeloid leukemia. Despite this, the international medical community has recommended delaying the start of chemotherapy until clinical symptoms of coronavirus infection have completely resolved and a negative test result for SARS-CoV-2 has been obtained for all types of leukemia. Currently, the most optimal tactic is to prevent SARS-CoV-2 infection by vaccinating patients with acute leukemia receiving antitumor treatment. If the immunological response to vaccination is insufficient, it is possible to use virus-neutralizing monoclonal antibodies as a safe and effective method of primary prevention of COVID-19.

About the Authors

T. S. Chudnova
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation

Tatiana S. Chudnova.

3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991



E. N. Misyurina
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation

3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991



E. A. Baryakh
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University); Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation

3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991; Build. 1, 2 / 1 Barrikadnaya St., Moscow 125993; 1 Ostrovityanova St., Moscow 117997



T. N. Tolstykh
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation

3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991



L. T. Shimanovskaya
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation

3 Pekhotnaya St., Moscow 123182



D. E. Gagloeva
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation

3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991



E. I. Zhelnova
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation

3 Pekhotnaya St., Moscow 123182



A. B. Makeshova
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation

3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991



K. V. Yatskov
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation

3 Pekhotnaya St., Moscow 123182



E. N. Zotina
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation

3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991



D. D. Ivanova
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation

3 Pekhotnaya St., Moscow 123182



M. A. Mingalimov
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation

3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991



O. L. Kochneva
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation

3 Pekhotnaya St., Moscow 123182



E. Yu. Grishina
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation

3 Pekhotnaya St., Moscow 123182



Yu. Yu. Polyakov
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation

3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991



V. N. Yakimets
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation

3 Pekhotnaya St., Moscow 123182



References

1. Mathieu E., Ritchie H., Rodes-Guirao L. et al. Coronavirus (COVID-19) Deaths. Available at: https://ourworldindata.org/covid-deaths.

2. Gregory A. Covid-19 is no longer a global health emergency, says WHO. Available at: https://www.theguardian.com/world/2023/may/05/covid-19-no-longer-global-health-emergency-world-health-organization.

3. Worldometr. COVID-19 coronavirus pandemic. Available at: https://www.worldometers.info/coronavirus/.

4. Dessie Z.G., Zewotir T. Mortality-related risk factors of COVID-19: a systematic review and meta-analysis of 42 studies and 423,117 patients. BMC Infect Dis 2021;21(1):855. DOI: 10.1186/s12879-021-06536-3

5. Liang W., Guan W., Chen R. et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol 2020;21(3):335-7. DOI: 10.1016/S1470-2045(20)30096-6

6. Rubinstein S., Lynch R.C., Desai A. et al. Severity of SARS-CoV-2 infection in patients with hematologic malignancies: a COVID-19 and Cancer Consortium (CCC19) registry analysis. Blood 2020;136:28-30. DOI: 10.1182/blood-2020-141937

7. Roel E., Pistillo A., Recalde M. et al. Cancer and the risk of coronavirus disease 2019 diagnosis, hospitalisation and death: a population-based multistate cohort study including 4 618 377 adults in Catalonia, Spain. Int J Cancer 2022;150(5):782-94. DOI: 10.1002/ijc.33846

8. Russell B., Moss C.L., Shah V. et al. Risk of COVID-19 death in cancer patients: an analysis from Guy's Cancer Centre and King's College Hospital in London. Br J Cancer 2021;125(7):939-47. DOI: 10.1038/s41416-021-01500-z

9. Varnai C., Palles C., Arnold R. et al. Mortality among adults with cancer undergoing chemotherapy or immunotherapy and infected with COVID-19. JAMA Netw Open 2022;5(2):e220130. DOI: 10.1001/jamanetworkopen.2022.0130. Erratum in: JAMA Netw Open 2022;5(4):e2210276.

10. Lee L.Y.W., Cazier J.B., Starkey T. et al. 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):1309-16. DOI: 10.1016/S1470-2045(20)30442-3

11. Passamonti F., Cattaneo C., Arcaini L. et al. Clinical characteristics and risk factors associated with COVID-19 severity in patients with haematological malignancies in Italy: a retrospective, multicentre, cohort study. Lancet Haematol 2020;7(10):e737-45. DOI: 10.1016/S2352-3026(20)30251-9

12. García­Suárez J., de la Cruz J., Cedillo Á. et al. 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

13. Palanques­Pastor T., Megías­Vericat J.E., Martínez P. et al. Characteristics, clinical outcomes, and risk factors of SARS-COV-2 infection in adult acute myeloid leukemia patients: experience of the PETHEMA group. Leuk Lymphoma 2021;62(12):2928-38. DOI: 10.1080/10428194.2021.1948031

14. Ribera J.M., Morgades M., Coll R. et al. Frequency, clinical characteristics and outcome of adults with acute lymphoblastic leukemia and COVID 19 infection in the first vs. second pandemic wave in Spain. Clin Lymphoma Myeloma Leuk 2021;21(10):e801-9. DOI: 10.1016/j.clml.2021.06.024

15. Pagano L., Salmanton-Garda J., Marchesi F. et al. 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

16. Visco C., Marcheselli L., Mina R. et al. A prognostic model for patients with lymphoma and COVID-19: a multicentre cohort study. Blood Adv 2022;6(1):327-38. DOI: 10.1182/bloodadvances.2021005691. Erratum in: Blood Adv 2023;7(6):1065.

17. Merli M., Ferrarini I., Merli F. et al. SARS-CoV-2 infection in patients with chronic lymphocytic leukemia: The Italian Hematology Alliance on COVID-19 cohort. Hematol Oncol 2023;41(1):128-38. DOI: 10.1002/hon.3092

18. Pinana J.L., Martino R., Garda-Garda I. et al. 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

19. Mushtaq M.U., Shahzad M., Chaudhary S.G. et al. Impact of SARS-CoV-2 in hematopoietic stem cell transplantation and chimeric antigen receptor T cell therapy recipients. Transplant Cell Ther 2021;27(9):796.e1-7. DOI: 10.1016/j.jtct.2021.07.005

20. Stahl M., Narendra V., Jee J. et al. Neutropenia in adult acute myeloid leukemia patients represents a powerful risk factor for COVID-19 related mortality. Leuk Lymphoma 2021;62(8):1940-8. DOI: 10.1080/10428194.2021.1885664

21. Demichelis-Gomez R., Alvarado-Ibarra M., Vasquez-Chavez J. et al. Treating acute leukemia during the COVID-19 pandemic in an environment with limited resources: a multicenter experience in four Latin American countries. JCO Glob Oncol 2021;7:577-84. DOI: 10.1200/GO.20.00620

22. Marchesi F., Salmanton-Garda J., Emarah Z. et al. COVID-19 in adult acute myeloid leukemia patients: a long-term follow-up study from the European Hematology Association survey (EPICOVIDEHA). Haematologica 2023;108(1):22-33. DOI: 10.3324/haematol.2022.280847

23. Martinez P., Palanques Pastor T., Lopez Lorenzo J.L. et al. Impact of SARS-CoV-2 infection in acute myeloid leukemia patients: experience of the pethema registry. Blood 2020;136:7-8. DOI: 10.1182/blood-2020-138471

24. Modemann F., Ghandili S., Schmiedel S. et al. COVID-19 and adult acute leukemia: our knowledge in progress. Cancers (Basel) 2022;14(15):3711. DOI: 10.3390/cancers14153711

25. Chiaretti S., Bonifacio M., Agrippino R. et al. COVID-19 infection in acute lymphoblastic leukemia over 15 months of the pandemic. A Campus ALL report. Haematologica 2022;107(8):1955-9. DOI: 10.3324/haematol.2021.280289

26. Cesaro S., Ljungman P., Mikulska M. et al. Recommendations for the management of COVID-19 in patients with haematological malignancies or haematopoietic cell transplantation, from the 2021 European Conference on Infections in Leukaemia (ECIL 9). Leukemia 2022;36(6):1467-80. DOI: 10.1038/s41375-022-01578-1

27. Arcani R., Colle J., Cauchois R. et al. Clinical characteristics and outcomes of patients with haematologic malignancies and COVID-19 suggest that prolonged SARS-CoV-2 carriage is an important issue. Ann Hematol 2021;100(11):2799-803. DOI: 10.1007/s00277-021-04656-z

28. Kawasuji H., Morinaga Y., Tani H. et al. SARS-CoV-2 RNAemia with a higher nasopharyngeal viral load is strongly associated with disease severity and mortality in patients with COVID-19. J Med Virol 2022;94(1):147-53. DOI: 10.1002/jmv.27282

29. Babady N.E., Cohen B., McClure T. et al. Variable duration of viral shedding in cancer patients with coronavirus disease 2019 (COVID-19). Infect Control Hosp Epidemiol 2022;43(10):1413-5. DOI: 10.1017/ice.2021.378

30. Gur I., Giladi A., Isenberg Y.N. et al. COVID-19 in patients with hematologic malignancies: clinical manifestations, persistence, and immune response. Acta Haematol 2022;145(3):297-309. DOI: 10.1159/000523872

31. Singh S., Singh J., Paul D., Jain K. Treatment of acute leukemia during COVID-19: focused review of evidence. Clin Lymphoma Myeloma Leuk 2021;21(5):289-94. DOI: 10.1016/j.clml.2021.01.004

32. Martín­Moro F., Núnez­Torrón C., Pérez­Lamas L. et al. The impact of lockdown during the COVID-19 pandemic on newly acute myeloid leukemia patients: single-centre comparative study between 2019 and 2020 cohorts in Madrid. Leuk Res 2021;101:106518. DOI: 10.1016/j.leukres.2021.106518

33. Ripa M., Galli L., Poli A. et al. Secondary infections in patients hospitalized with COVID-19: incidence and predictive factors. Clin Microbiol Infect 2021;27(3):451-7. DOI: 10.1016/j.cmi.2020.10.021

34. Samantaray S., Karan P., Sharma A. et al. Prevalence, presentation and outcome of secondary bloodstream infections among COVID-19 patients. Infect Disord Drug Targets 2022;22(5):e180422203723. DOI: 10.2174/1871526522666220418093450

35. Jing Y., Luo L., Chen Y. et al. SARS-CoV-2 infection causes immunodeficiency in recovered patients by downregulating CD19 expression in B cells via enhancing B-cell metabolism. Sig Transduct Target Ther 2021;6:345. DOI: 10.1038/s41392-021-00749-3

36. Zeidan A.M., Boddu P.C., Patnaik M.M. et al. Special considerations in the management of adult patients with acute leukaemias and myeloid neoplasms in the COVID-19 era: recommendations from a panel of international experts. Lancet Haematol 2020;7(8):e601-12. DOI: 10.1016/S2352-3026(20)30205-2

37. Tallman M., Rollig C., Zappasodi P. et al. COVID-19 and acute myeloid leukemia: frequently asked questions. 2022. Available at: https://www.hematology.org/covid-19/covid-19-and-acute-myeloid-leukemia.

38. Ghandili S., Pfefferle S., Roedl K. et al. Challenges in treatment of patients with acute leukemia and COVID-19: a series of 12 patients. Blood Adv 2020;4(23):5936-41. DOI: 10.1182/bloodadvances.2020002543

39. Altamirano-Molina M., Pacheco-Modesto I., Amado-Tineo J. Prolonged viral shedding of SARS-CoV-2 in patients with acute leukemia. Hematol Transfus Cell Ther 2022;44(2):299-300. DOI: 10.1016/j.htct.2021.11.017

40. Recommendations for the management of patients with AML during the COVID19 outbreak: a statement from the NCRI AML Working Party. Available at: https://www.rcpath.org/static/d23030b6-7379-4f80-9ed9178c5f864343/Recommendations-for-the-management-of-patients-with-acute-myeloid-leukaemia-AML-during-the-COVID19-outbreak.pdf.

41. Stock W., Patel A.A., O'Dwyer K. et al. American Society of Hematology. COVID-19 and adult ALL: frequently asked questions. Available at: https://www.hematology.org/covid-19/covid-19-and-all

42. Brissot E., Labopin M., Baron F. et al. Management of patients with acute leukemia during the COVID-19 outbreak: practical guidelines from the acute leukemia working party of the European Society for Blood and Marrow Transplantation. Bone Marrow Transplant 2021;56(3):532-5. DOI: 10.1038/s41409-020-0970-x

43. Foà R., Bonifacio M., Chiaretti S. et al. Philadelphia-positive acute lymphoblastic leukaemia (ALL) in Italy during the COVID-19 pandemic: a Campus ALL study. Br J Haematol 2020;190(1):e3-5. DOI: 10.1111/bjh.16758

44. Grivas P., Khaki A.R., Wise-Draper T.M. et al. Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: a report from the COVID-19 and Cancer Consortium. Ann Oncol 2021;32(6):787-800. DOI: 10.1016/j.annonc.2021.02.024

45. Liu X., Zhang R., He G. Hematological findings in coronavirus disease 2019: indications of progression of disease. Ann Hematol 2020;99(7):1421-8. DOI: 10.1007/s00277-020-04103-5

46. Henry B., Cheruiyot I., Vikse J. et al. Lymphopenia and neutrophilia at admission predicts severity and mortality in patients with COVID-19: a meta-analysis. Acta Biomed 2020;91(3):e2020008. DOI: 10.23750/abm.v91i3.10217

47. Barnes B.J., Adrover J.M., Baxter-Stoltzfus A. et al. Targeting potential drivers of COVID-19: neutrophil extracellular traps. J Exp Med 2020;217(6):e20200652. DOI: 10.1084/jem.20200652

48. Effah C.Y., Drokow E.K., Agboyibor C. et al. Neutrophildependent immunity during pulmonary infections and inflammations. Front Immunol 2021;12:689866. DOI: 10.3389/fimmu.2021.689866

49. Zhang A.W., Morjaria S., Kaltsas A. et al. The effect of neutropenia and filgrastim (G-CSF) on cancer patients with coronavirus disease 2019 (COVID-19) infection. Clin Infect Dis 2022;74(4):567-74. DOI: 10.1093/cid/ciab534

50. Lasagna A., Muzzana M., Pedrazzoli P. Lights and shadows on the role of rhG-CSF in cancer patients during the COVID-19 pandemic and future perspectives of research. Immunotherapy 2021;13(17):1369-72. DOI: 10.2217/imt-2021-0219

51. Sereno M., Jimenez-Gordo A.M., Baena-Espinar J. et al. A multicenter analysis of the outcome of cancer patients with neutropenia and COVID-19 optionally treated with granulocytecolony stimulating factor (G-CSF): a comparative analysis. Cancers (Basel) 2021;13(16):4205. DOI: 10.3390/cancers13164205

52. Nawar T., Morjaria S., Kaltsas A. et al. Granulocyte-colony stimulating factor in COVID-19: Is it stimulating more than just the bone marrow? Am J Hematol 2020;95(8):E210-13. DOI: 10.1002/ajh.25870

53. Clinical guidelines Acute myeloid leukemia, 2020. Available at: https://old.oncology-association.ru/files/clinical-guidelines-2020/ostrye_mieloidnye_lejkozy.pdf. (In Russ.).

54. Clinical guidelines Acute lymphoblastic leukemia, 2020. Available at: https://oncology-association.ru/wp-content/uploads/2020/09/oll.pdf. (In Russ.).

55. Greenberger L.M., Saltzman L.A., Senefeld J.W. et al. Antibody response to SARS-CoV-2 vaccines in patients with hematologic malignancies. Cancer Cell 2021;39(8):1031-3. DOI: 10.1016/j.ccell.2021.07.012

56. Candoni A., Callegari C., Zannier M.E. et al. Antibody response to mRNA vaccination for COVID-19 in patients with AML receiving hypomethylating agents alone or with venetoclax. Blood Adv 2022;6(10):3068-71. DOI: 10.1182/bloodadvances.2021006949

57. Jain A.G., Dong N.C., Ball S. et al. Responses to SARS-CoV-2 vaccines in patients with myelodysplastic syndrome and acute myeloid leukemia. Blood 2021;138:217. DOI: 10.1182/blood-2021-151669

58. Temporary guidelines. Prevention, diagnosis and treatment of new coronavirus infection (COVID-19). Version 3 (03.03.2020). Ministry of Health of Russia. Available at: https://www.amursma.ru/upload/docs/COVID/VMR/Vremennye_MR_COVID-19_03.03.2020__versija_3__6-6_ver1.pdf. (In Russ.).

59. Temporary guidelines. Prevention, diagnosis and treatment of new coronavirus infection (COVID-19). Version 4 (27.03.2020). Ministry of Health of Russia. Available at: https://www.amursma.ru/upload/docs/COVID/VMR/COVID19_recomend_v4.pdf. (In Russ.).

60. Ader F., Bauer J. What progress has been made in treatment of immunocompromised COVID-19 patients? Infect Dis Now 2022;52(8S):S12-5. DOI: 10.1016/j.idnow.2022.09.009

61. Temporary guidelines. Prevention, diagnosis and treatment of new coronavirus infection (COVID-19). Version 6 (28.04.2020). Ministry of Health of Russia. Available at: https://www.amursma.ru/upload/docs/COVID/VMR/28042020_MR_COVID-19_v6.pdf. (In Russ.).

62. Temporary guidelines. Prevention, diagnosis and treatment of new coronavirus infection (COVID-19). Version 8 (03.09.2020). Ministry of Health of Russia. Available at: https://www.amursma.ru/upload/docs/COVID/VMR/030902020_COVID-19_v8.pdf. (In Russ.).

63. Temporary guidelines. Prevention, diagnosis and treatment of new coronavirus infection (COVID-19). Version 11 (07.05.2021). Ministry of Health of Russia. Available at: https://www.amursma.ru/upload/docs/COVID/VMR/VMR_COVID_-19_Versiya_11_07.05.2021.pdf. (In Russ.).

64. Klank D., Claus B., Bergner R. et al. Single center experience using monoclonal COVID-19 antibodies in the management of immunocompromised patients with COVID-19. Microorganisms 2022;10(12):2490. DOI: 10.3390/microorganisms10122490

65. Owen C., Robinson S., Christofides A. et al. A Canadian perspective: monoclonal antibodies for pre- and post-exposure protection from COVID-19 in vulnerable patients with hematological malignancies. Curr Oncol 2022;29(6):3940-9. DOI: 10.3390/curroncol29060315


Review

For citations:


Chudnova T.S., Misyurina E.N., Baryakh E.A., Tolstykh T.N., Shimanovskaya L.T., Gagloeva D.E., Zhelnova E.I., Makeshova A.B., Yatskov K.V., Zotina E.N., Ivanova D.D., Mingalimov M.A., Kochneva O.L., Grishina E.Yu., Polyakov Yu.Yu., Yakimets V.N. COVID-19 in patients with acute leukemia: 3 years' experience of pandemic. Oncohematology. 2023;18(4):45-52. (In Russ.) https://doi.org/10.17650/1818-8346-2023-18-4(Suppl)-45-52

Views: 2296


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1818-8346 (Print)
ISSN 2413-4023 (Online)