COVID-19 Mortality Higher in Blood Cancer Patients Than in General Population

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The rate of death from COVID-19 is substantially higher in patients with hematologic malignancies than in the general population, according to a poster presentation at the 2021 American Society of Hematology (ASH) Annual Meeting.

The findings come from the ASH Research Collaborative COVID-19 Registry for Hematology, a public registry that reports outcomes of COVID-19 in patients with blood disorders.

Researchers used the registry data to evaluate the effect of patient and disease characteristics on mortality and hospitalization due to COVID-19 in patients with hematologic malignancies.


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The analysis included 1029 patients entered into the registry between April 1, 2020, and July 2, 2021. Patients had acute leukemia or myelodysplastic syndromes (MDS; n=354), lymphoma (n=255), plasma cell dyscrasia (n=206), chronic lymphocytic leukemia (n=116), or myeloproliferative neoplasms (MPNs; n=98).

About half of patients (49%) had active disease, 71% had received systemic therapy within the previous year, and 7% had a pre-COVID-19 estimated prognosis of 6 months or less. Major comorbidities — including heart disease, respiratory disease, diabetes, and hypertension — were present in 27% of the cohort.

Hospitalization

The rate of COVID-19 hospitalization was 53%. In a multivariate analysis, hospitalization was significantly associated with:

  • Age 60 years or older (odds ratio [OR], 2.44; 95% CI, 1.82-3.30)
  • Male sex (OR, 1.32; 95% CI, 1.00-1.74)
  • The presence of major comorbidities (OR, 1.54; 95% CI, 1.12-2.13)
  • Active cancer (OR, 1.66; 95% CI, 1.24-2.23)
  • A pre-COVID-19 prognosis of 6 months or less (OR, 3.84; 95% CI, 1.93-8.43).

When compared with patients who had acute leukemia/MDS, the odds of hospitalization were lower among patients with plasma cell dyscrasia (OR, 0.55; 95% CI, 0.37-0.82) and those with MPNs (OR, 0.41; 95% CI, 0.24-0.70).

Mortality

The mortality rate was 17% for the entire cohort, 30% among patients who required hospitalization, and 1% among patients who were not hospitalized.

In comparison, the case fatality rate of COVID-19 within the United States has been reported as ranging from 1.62% to 6.25%, according to the researchers.

The team emphasized that the mortality estimates from this study should be interpreted with caution because hospitalized patients are likely over-represented in the registry, and the registry includes cases of asymptomatic COVID-19.

In a multivariate analysis, COVID-19 mortality was significantly associated with the following factors:

  • Age 60 years or older (OR, 1.99; 95% CI, 1.28-3.12)
  • Male sex (OR, 1.70; 95% CI, 1.12-2.62)
  • A pre-COVID-19 prognosis of 6 months or less (OR, 5.76; 95% CI, 2.99-11.21)
  • Deferring ICU care (OR, 10.76; 95% CI, 6.29-18.80).

“[I]t is not clear to what extent patients with terminal blood cancer are uniquely susceptible to poor COVID outcomes, and to what extent it is their care preferences that influence their mortality,” the researchers wrote.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Read more of Cancer Therapy Advisor’s coverage of the ASH 2021 meeting by visiting the conference page.

Reference

Hicks LK, Redd RA, Anderson KC, et al. Risks for hospitalization and death among patients with malignant blood disorders from the ASH RC COVID-19 Registry for Hematology. Presented at ASH 2021; December 11-14, 2021. Abstract 3040.



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