High Rates of COVID-19 Mortality Seen in Patients With Hematological Malignancies

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Patients with hematological malignancies and COVID-19 had a high mortality rate, according to the results of a study presented during the European Society for Medical Oncology (ESMO) Congress 2021.

CHRONOS19 (ClinicalTrials.gov Identifier: NCT04422470) is an ongoing observational study in adult patients with malignant and non-malignant hematological diseases and COVID-19 in Russia. The web-based registry collected deidentified patient data from 15 centers at 30, 90, and 180 days after lab-confirmed or suspected COVID-19 diagnosis. The primary endpoint is 30-day all-cause mortality. The data cutoff date for the reported analysis was April 14, 2021.

At data cutoff, 562 of 626 patients enrolled in the study were eligible for primary endpoint assessment. Of those assessed, the median age was 56 years (range, 18-90). Males and females were nearly equally represented (48% and 52%). Most (92%) had malignant disease. Of them, 35% were undergoing induction; 23% had relapse or refractory disease; and 36% were in remission.


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The 30-day all-cause mortality rate in patients with hematological malignancies was 19%. Most (83%) deaths were due to COVID-19 complications. No increase was observed in the hematological disease relapse rate at Day 90 following COVID-19. The data are still maturing for the 180-day analysis.

Among patients with hematological malignancies, detectable immunoglobulin (Ig) G to SARS-CoV-2 was present in 84%. Patients with chronic myeloproliferative neoplasms (100%), Hodgkin lymphoma (HL; 100%), and multiple myeloma (97%) demonstrated the highest rates of detectable antibody, while patients with chronic lymphocytic leukemia (62%) and non-Hodgkin lymphoma (low-grade: 60%, high-grade: 74%) had the lowest rates.

The antibody detection rate was significantly lower in CD20+ lymphoma (60%) than in HL or T-cell lymphoma (P =.004). Patients with ECOG 0-2 during COVID-19 had a high rate of detectable antibody (90%); however, those with ECOG 3-4 at the time of COVID-19 diagnosis (77.5%) or with worsening of ECOG to 3-4 during COVID-19 (78%) had lower rates. The study authors also reported 5 cases of SARS-CoV-2 re-infection.

“Patients with hematological malignancies and COVID-19 have higher mortality than the general population,” concluded the authors. “Low post-disease antibody immunity to SARS-CoV-2 and cases of re-infection may justify vaccination of these patients and warrant further research.”

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

Reference

Zakurdaeva K, Gavrilina O, Vasileva A, et al. Treatment outcomes and antibody immunity to SARS-CoV-2 in patients with hematological malignancies. Presented at: European Society for Medical Oncology (ESMO) Congress 2021; September 16-21, 2021. Abstract 1590P.

This article originally appeared on Hematology Advisor



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