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Marchesi F, Salmanton-García J, Emarah Z, Piukovics K, Nucci M, López-García A, Rácil Z, Farina F, Popova M, Zompi S, Audisio E, Ledoux MP, Verga L, Weinbergerová B, Szotkovski T, Da Silva MG, Fracchiolla N, De Jonge N, Collins G, Marchetti M, Magliano G, García-Vidal C, Biernat MM, Van Doesum J, Machado M, Demirkan F, Al-Khabori M, Žák P, Víšek B, Stoma I, Méndez GA, Maertens J, Khanna N, Espigado I, Dragonetti G, Fianchi L, Del Principe MI, Cabirta A, Ormazabal-Vélez I, Jaksic O, Buquicchio C, Bonuomo V, Batinié J, Omrani AS, Lamure S, Finizio O, Fernández N, Falces-Romero I, Blennow O, Bergantim R, Ali N, Win S, Van Praet J, Tisi MC, Shirinova A, Schönlein M, Prattes J, Piedimonte M, Petzer V, Navrátil M, Kulasekararaj A, Jindra P, Sramek J, Glenthøj A, Fazzi R, De Ramón-Sánchez C, Cattaneo C, Calbacho M, Bahr NC, El-Ashwah S, Cordoba R, Hanakova M, Zambrotta GPM, Zambrotta G, Sciumè M, Booth S, Rodrigues RN, Sacchi MV, García-Poutón N, Martín-González JA, Khostelidi S, Gräfe S, Rahimli L, Ammatuna E, Busca A, Corradini P, Hoenigl M, Klimko N, Koehler P, Pagliuca A, Passamonti F, Cornely OA, Pagano L. COVID-19 in adult acute myeloid leukemia patients: a long-term follow-up study from the European Hematology Association survey (EPICOVIDEHA). Haematologica 2022; 108:22-33. [PMID: 35545919 PMCID: PMC9827164 DOI: 10.3324/haematol.2022.280847] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Indexed: 02/04/2023] Open
Abstract
Patients with acute myeloid leukemia (AML) are at high risk of dying from coronavirus disease 2019 (COVID-19). The optimal management of AML patients with COVID-19 has not been established. Our multicenter study included 388 adult AML patients diagnosed with COVID-19 between February 2020 and October 2021. The vast majority were receiving or had received AML treatment in the preceding 3 months. COVID-19 was severe in 41.2% and critical in 21.1% of cases. The chemotherapeutic schedule was modified in 174 patients (44.8%), delayed in 68 and permanently discontinued in 106. After a median follow-up of 325 days, 180 patients (46.4%) had died; death was attributed to COVID-19 (43.3%), AML (26.1%) or to a combination of both (26.7%), whereas in 3.9% of cases the reason was unknown. Active disease, older age, and treatment discontinuation were associated with death, whereas AML treatment delay was protective. Seventy-nine patients had a simultaneous AML and COVID-19 diagnosis, with better survival when AML treatment could be delayed (80%; P<0.001). Overall survival in patients with a diagnosis of COVID-19 between January 2020 and August 2020 was significantly lower than that in patients diagnosed between September 2020 and February 2021 and between March 2021 and September 2021 (39.8% vs. 60% vs. 61.9%, respectively; P=0.006). COVID-19 in AML patients was associated with a high mortality rate and modifications of therapeutic algorithms. The best approach to improve survival was to delay AML treatment, whenever possible.
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Affiliation(s)
- Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy,FM and JSG contributed equally as co-first authors
| | - Jon Salmanton-García
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany,FM and JSG contributed equally as co-first authors
| | - Ziad Emarah
- Oncology Center, Mansoura University, Mansoura, Egypt
| | - Klára Piukovics
- Department of Internal Medicine, South Division Faculty of Medicine University of Szeged, Szeged, Hungary
| | - Marcio Nucci
- Department of Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alberto López-García
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Zdenék Rácil
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | | | - Marina Popova
- RM Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russia
| | - Sofia Zompi
- Stem Cell Transplant Center, AOU Citta' della Salute e della Scienza, Turin, Italy
| | - Ernesta Audisio
- Stem Cell Transplant Center, AOU Citta' della Salute e della Scienza, Turin, Italy
| | | | - Luisa Verga
- Azienda Ospedaliera San Gerardo - Monza, Monza, Italy,Università Milano-Bicocca, Milan, Italy
| | - Barbora Weinbergerová
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno, Brno, Czech Republic
| | | | | | - Nicola Fracchiolla
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nick De Jonge
- Amsterdam UMC, location VUmc, Amsterdam, the Netherlands
| | | | - Monia Marchetti
- Azienda Ospedaliera Nazionale “SS. Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | | | - Carolina García-Vidal
- Department of Infectious Diseases, Hospital Clinic de Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Monika M. Biernat
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Jaap Van Doesum
- University Medical Center Groningen, Groningen, the Netherlands
| | - Marina Machado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Fatih Demirkan
- Division of Hematology, Dokuz Eylul University, Izmir, Turkey
| | | | - Pavel Žák
- University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Benjamín Víšek
- University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Igor Stoma
- Gomel State Medical University, Gomel, Belarus
| | | | - Johan Maertens
- Department of Microbiology, Immunology, and Transplantation, KULeuven and Department of Hematology, UZ Leuven, Leuven, Belgium
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, and Department of Clinical Research, University and University Hospital of Basel, Basel, Switzerland
| | - Ildefonso Espigado
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC), Universidad de Sevilla, Seville, Spain
| | - Giulia Dragonetti
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | - Luana Fianchi
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | | | - Alba Cabirta
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain,Department of Hematology, Vall d’Hebron Hospital Universitari, Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | | | | | | | - Valentina Bonuomo
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Josip Batinié
- Croatian Cooperative Group for Hematological Diseases (CROHEM), Zagreb, Croatia,Faculty of Medicine University of Zagreb, Zagreb, Croatia,University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ali S. Omrani
- Hamad Medical Corporation, Division of Infectious Diseases, Doha, Qatar
| | - Sylvain Lamure
- Département d’Hématologie Clinique, CHU de Montpellier, UMR-CNRS 5535, Universite de Montpellier, Montpellier, France
| | | | - Noemí Fernández
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Rui Bergantim
- Centro Hospitalar e Universitário São João, Porto, Portugal
| | - Natasha Ali
- Aga Khan University Hospital, Karachi, Pakistan
| | - Sein Win
- Department of Clinical Hematology, Yangon General Hospital, University of Medicine, Yangon, Myanmar
| | - Jens Van Praet
- Department of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | | | - Ayten Shirinova
- Azerbaijan Scientific Research Hematology and Transfusiology Institute, Baku, Azerbaijan
| | - Martin Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Juergen Prattes
- Medical University of Graz, Department for Infectious Diseases, Graz, Austria
| | | | - Verena Petzer
- Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Milan Navrátil
- Head of the ICU and Transplant Unit, Department of Hematooncology, University Hospital of Ostrava, Ostrava-Poruba, Czech Republic
| | | | - Pavel Jindra
- University Hospital Pilsen, Pilsen, Czech Republic
| | - Jirí Sramek
- Department of Hematology and Oncology, University Hospital Pilsen, Pilsen, Czech Republic,Department of Histology and Embryology, Faculty of Medicine, Pilsen, Czech Republic
| | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Rita Fazzi
- AOUP - Azienda Ospedaliera Università Pisana - Cisanello, Pisa, Italy
| | - Cristina De Ramón-Sánchez
- Hematology Department, Hospital Universitario de Salamanca, Salamanca, Spain,IBSAL, Centro de Investigación del Cáncer-IBMCC (USAL-CSIC), Salamanca, Spain
| | | | | | | | | | - Raul Cordoba
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Michaela Hanakova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | | | | | - Mariarita Sciumè
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | - Maria Vittoria Sacchi
- Azienda Ospedaliera Nazionale “SS. Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | - Nicole García-Poutón
- Department of Infectious Diseases, Hospital Clinic de Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
| | | | - Sofya Khostelidi
- North-Western State Medical University named after Iliá Ilich Méchnikov, Saint-Petersburg, Russia
| | - Stefanie Gräfe
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany,Universitätsklinikum Hamburg Eppendorf, Hamburg, Germany
| | - Laman Rahimli
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | | | - Alessandro Busca
- Stem Cell Transplant Center, AOU Citta' della Salute e della Scienza, Turin, Italy
| | - Paolo Corradini
- University of Milan and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Martin Hoenigl
- Clinical and Translational Fungal-Working Group, University of California San Diego, La Jolla, CA, USA,Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, CA, USA,Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Nikolai Klimko
- North-Western State Medical University named after Iliá Ilich Méchnikov, Saint-Petersburg, Russia
| | - Philipp Koehler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Antonio Pagliuca
- Department of Haematological Medicine, Kings College Hospital NHS Foundation Trust, London, UK
| | - Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Oliver A. Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany,OAC and LP contributed equally as co-senior authors
| | - Livio Pagano
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy,Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy,OAC and LP contributed equally as co-senior authors
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