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Delgado N, Torres A. What Do We Currently Know About Chronic Myeloid Leukemia (CML) and COVID-19? Curr Oncol Rep 2022; 24:645-650. [PMID: 35218499 PMCID: PMC8881701 DOI: 10.1007/s11912-021-01169-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW COVID-19 is highly contagious; since it was first identified, the virus has rapidly spread to more than 100 countries and was declared a pandemic on March 11, 2020, by the World Health Organization (WHO). This disease presents several challenges when managing patients with leukemia. We review the information about chronic myeloid leukemia (CML) and COVID-19: risk factors, prognosis, and the role of tyrosine kinase inhibitors (TKIs). RECENT FINDINGS At present, we find no data suggesting that patients with CML-chronic phase (CML-CP) are at higher risk of infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) than the general healthy population. TKIs had been proposed to fight the SARS-CoV-2-related disease (COVID-19). CML patients should continue receiving their TKIs if they have COVID-19 disease. The role of TKIs as protective factors against SARS-CoV-2 infection in patients with CML should be confirmed by large-scale epidemiologic studies.
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Affiliation(s)
- Nancy Delgado
- Department of Hematology, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
| | - Anahí Torres
- Department of Hematology, Hospital General Regional No 72, Instituto Mexicano del Seguro Social, Ciudad de México, Estado de México, México
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Nesr G, Saleem Z, Arami S. Outcome of COVID-19 in patients with chronic myeloid leukemia: A single centre UK experience. J Med Virol 2021; 94:1274-1276. [PMID: 34914847 DOI: 10.1002/jmv.27527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/03/2021] [Accepted: 12/14/2021] [Indexed: 11/10/2022]
Affiliation(s)
- George Nesr
- Haematology Department, London North West University Healthcare NHS Trust, London, UK
| | - Zahbia Saleem
- Haematology Department, London North West University Healthcare NHS Trust, London, UK
| | - Siamak Arami
- Haematology Department, London North West University Healthcare NHS Trust, London, UK
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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; 62:3212-3218. [PMID: 34254886 DOI: 10.1080/10428194.2021.1950709] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This observational, multicenter study aimed to report the clinical evolution of COVID-19 in patients with chronic myeloid leukemia in Latin America. A total of 92 patients presented with COVID-19 between March and December 2020, 26% of whom were severe or critical. The median age at COVID-19 diagnosis was 48 years (22-79 years), 32% were 60 years or older, and 61% were male. Thirty-nine patients presented with at least one comorbidity (42.3%). Eighty-one patients recovered (88%), and 11 (11.9%) died from COVID-19. There was one case of reinfection. Patients with a major molecular response presented superior overall survival compared to patients with no major molecular response (91 vs. 61%, respectively; p = 0.004). Patients in treatment-free remission and receiving tyrosine kinase inhibitors showed higher survival rates than patients who underwent hematopoietic stem cell transplantation and those who did not receive tyrosine kinase inhibitors (100, 89, 50, and 33%, respectively; p < 0.001).
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Affiliation(s)
- Katia B Pagnano
- Hematology and Hemotherapy Center, University of Campinas, Campinas, SP, Brazil
| | | | | | | | - Nancy Delgado
- Centro Médico Nacional Siglo XXI IMSS, Cuauhtémoc, México Ciudad de México
| | | | | | - Leila M Perobelli
- Hospital de Transplantes Euryclides de Jesus Zerbini, São Paulo, Brazil
| | - Leonardo Fechio
- Hematology and Hemotherapy Center, University of Campinas, Campinas, SP, Brazil
| | - Acy T S Quixada
- Faculdade de Medicina da Universidade Federal do Ceará, Hospital Universitário Walter Cantídio, Fortaleza, Brazil
| | - Vaneuza Funke
- Complexo Hospital de Clínicas - Universidade Federal do Paraná, Curitiba, Brazil
| | - Israel Bendit
- Laboratory of Medical Investigation in Pathogenesis and targeted therapy in Onco-Immuno-Hematology (LIM/31), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Fernanda S Seguro
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | | | - Fabio M Nucci
- Hospital Universitário Antonio Pedro, Universidade Federal Fluminense, Niterói, Brazil
| | | | | | | | - Leonardo C Palma
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | | | | | - Paula O M Hokama
- São Paulo State University, UNESP, Medical School, Campus de Botucatu, Botucatu, Brazil
| | | | - Roberto Zulli
- Hematology and Hemotherapy Center, University of Campinas, Campinas, SP, Brazil
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Singh B, Ayad S, Kaur P, Kumar V, Gupta S, Maroules M. COVID-19-Induced Pancytopenia in a Major Molecular Response CML Patient on Dasatinib: A Case Report and Review of the Literature. Eur J Case Rep Intern Med 2021; 8:002233. [PMID: 33585346 DOI: 10.12890/2021_002233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 12/23/2020] [Indexed: 11/05/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), has caused a global health crisis. COVID-19 can have a multifaceted presentation, and a wide range of complications and outcomes may emerge based on the severity and comorbidities of the infected patient. We report the case of a 42-year-old man with a history of chronic myeloid leukaemia (CML) on dasatinib (in major molecular response) who was diagnosed with COVID-19 and developed pancytopenia. Our case report and review of available publications add to the limited literature available regarding COVID-19 in CML. LEARNING POINTS Our case report and review of the literature highlight the multifaceted response in chronic myeloid leukaemia (CML) patients to COVID-19 (respiratory symptoms, pancytopenia, severe haemolytic anaemia and haemophagocytic lymphohistiocytosis, disseminated erythematous papular skin rash).The rates of intensive care unit admission and mechanical ventilation support, and lengths of hospital stay were lower in COVID-19 patients with CML receiving tyrosine kinase inhibitors (TKI) compared with an age, gender and comorbidity-matched control group.Our case report and review of the literature suggest a possible protective effect of TKI therapy against COVID-19 in patients with CML.
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Affiliation(s)
- Balraj Singh
- Department of Hematology & Oncology, Saint Joseph's University Medical Center, Paterson, NJ, USA
| | - Sarah Ayad
- Department of Hematology & Oncology, Saint Joseph's University Medical Center, Paterson, NJ, USA
| | - Parminder Kaur
- Department of Cardiology, Saint Joseph's University Medical Center, Paterson, NJ, USA
| | - Vinod Kumar
- Department of Hematology & Oncology, Saint Joseph's University Medical Center, Paterson, NJ, USA
| | - Sachin Gupta
- Department of Internal Medicine, Tower Health Reading Hospital, West Reading, PA, USA
| | - Michael Maroules
- Department of Hematology & Oncology, Saint Joseph's University Medical Center, Paterson, NJ, USA
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Retamozo S, Brito-Zerón P, Sisó-Almirall A, Flores-Chávez A, Soto-Cárdenas MJ, Ramos-Casals M. Haemophagocytic syndrome and COVID-19. Clin Rheumatol 2021; 40:1233-1244. [PMID: 33389315 PMCID: PMC7778844 DOI: 10.1007/s10067-020-05569-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/19/2020] [Accepted: 12/22/2020] [Indexed: 12/15/2022]
Abstract
Primary and secondary haemophagocytic lymphohistiocytosis (HLH) are hyperferritinaemic hyperinflammatory syndromes with a common terminal pathway triggered by different etiopathogenetic factors. HLH is characterised by a decreased capacity of interferon gamma production with an activated NK phenotype profile similar to other hyperinflammatory syndromes. Viruses are closely linked to the development of HLH as infectious triggers, and the break of tolerance to self-antigens is considered a critical mechanism involved in the development of immune-mediated conditions triggered by viral infections. Emerging studies in patients with COVID-19 are suggesting a key role of monocytes/macrophages in the pathogenesis of this viral infection, and there is a significant overlap between several features reported in severe COVID-19 and the features included in the HLH-2004 diagnostic criteria. Therefore, SARS-Cov-2, as other respiratory viruses, may also be considered a potential etiological trigger of HLH. The frequency of HLH in adult patients with severe COVID-19 is lower than 5%, although this figure could be underestimated considering that most reported cases lacked information about some specific criteria (mainly the histopathological criteria and the measurement of NK cell function and sCD25 levels). Because HLH is a multi-organ syndrome, the diagnostic approach in a patient with severe COVID-19 in whom HLH is suspected must be carried out in a syndromic and holistic way, and not in the light of isolated clinical or laboratory features. In COVID-19 patients presenting with persistent high fever, progressive pancytopenia, and hepatosplenic involvement, together with the characteristic triad of laboratory abnormalities (hyperferritinaemia, hypertriglyceridaemia, and hypofibrinogenaemia), the suspicion of HLH is high, and the diagnostic workup must be completed with specific immunological and histopathological studies.
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Affiliation(s)
- Soledad Retamozo
- Instituto Modelo de Cardiología Privado S.R.L- Córdoba - Argentina, Instituto Universitario de Ciencias Biomédicas de Córdoba (IUCBC), Córdoba, Argentina
| | - Pilar Brito-Zerón
- Autoimmune Diseases Unit, Department of Medicine, Hospital CIMA- Sanitas, Barcelona, Spain
- Laboratory of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, Barcelona, Spain
| | - Antoni Sisó-Almirall
- Grup Tranversal de Recerca en Atenció Primària, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centre d'Atenció Primària Les Corts, Consorci d'Atenció Primària de Salut Barcelona Esquerre (CAPSBE), Barcelona, Spain
| | | | - María-José Soto-Cárdenas
- Department of Internal Medicine, Hospital Universitario Puerta del Mar, Cádiz, University of Cadiz, Cadiz, Spain
| | - Manuel Ramos-Casals
- Laboratory of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, Barcelona, Spain.
- Department of Medicine, University of Barcelona, Barcelona, Spain.
- Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain.
- Servei de Malalties Autoimmunes Sistèmiques, Hospital Clínic, C/Villarroel, 170, 08036, Barcelona, Spain.
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