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Ćojbašić I, Golubović I, Ćojbašić Ž. Clinical Outcomes of Patients with Chronic Myeloid Leukemia and COVID-19 Infection-A Single Center Survey. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1564. [PMID: 37763683 PMCID: PMC10533142 DOI: 10.3390/medicina59091564] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/22/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023]
Abstract
Background: Previous research has shown different effects of hematological malignancies on the outcome of patients with COVID-19 infection depending on the type of disease and the treatment received. This research was aimed at examining the clinical outcome of COVID-19 infection in positive patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors. Methods: We collected retrospective information on chronic myeloid leukemia patients who were treated and monitored in our institution during the pandemic period. Within this cohort, we recorded COVID-19 positive symptomatic patients and analyzed their basic characteristics, symptoms, severity, and outcome. Results: In the study cohort when COVID-19 was diagnosed, 86.7% of patients were on first-generation tyrosine kinase inhibitors therapy-imatinib. At the time of infection, 70% of patients were in molecular remission, 23.4% in complete cytogenetic remission, and 3.3% in complete hematological response. Most patients had symptomatic disease. Within the analyzed group, 56.7% of patients had asymptomatic/mild COVID-19 infection, 23.3% of patients had moderate symptoms which did not require hospitalization, and 20% of patients had severe/critical symptoms that required admission to the intensive care unit. More than half of the patients interrupted treatment with tyrosine kinase inhibitors temporarily during COVID-19. There were no deaths due to COVID-19 infection. Conclusions: In compliance with other larger clinical studies, analysis of the clinical outcome of COVID-19 infection in patients with chronic myeloid leukemia on tyrosine kinase inhibitors therapy in this study showed that they do not have an increased risk for COVID-19 infection and that they have a mild course of the disease with recovery.
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Affiliation(s)
- Irena Ćojbašić
- Faculty of Medicine, University of Niš, Blvd. Zorana Đinđića 81, 18000 Niš, Serbia;
- Clinic of Hematology, Allergology and Clinical Immunology, University Clinical Centre Niš, Blvd. Zorana Đinđića 48, 18000 Niš, Serbia;
| | - Ivana Golubović
- Clinic of Hematology, Allergology and Clinical Immunology, University Clinical Centre Niš, Blvd. Zorana Đinđića 48, 18000 Niš, Serbia;
| | - Žarko Ćojbašić
- Faculty of Mechanical Engineering, University of Niš, Aleksandra Medvedeva 14, 18000 Niš, Serbia
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Yılmaz U, Küçükyurt S, Tunç S, Eşkazan AE. Impact of the COVID-19 pandemic on the regular follow-up and outcomes of patients with chronic myeloid leukemia in chronic-phase. Front Oncol 2022; 12:994101. [PMID: 36276065 PMCID: PMC9582848 DOI: 10.3389/fonc.2022.994101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/14/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction COVID-19 immediately became a major consideration in the management of chronic myeloid leukemia (CML). The influence of such considerations on viral transmission rates and leukemic control remain to be explored. We conducted this study to identify these alterations and to investigate their clinical consequences. Methods This was a cross-sectional study, performed at a single institution on CML patients who were interviewed with a survey. We compared variables concerning new attitudes in the pandemic era between the 12-month periods before and after the pandemic onset. Outcome data were attained from the hospital archives. Findings The number of patients receiving regular outpatient care for CML in chronic phase was 210, 91% had achieved at least major molecular responses. We assessed survival, progression, number of clinical visits of all, performed the survey on 89% and evaluated molecular responses on 86.6% of these patients. The frequency of clinical and molecular monitoring was significantly reduced during the pandemic deviating significantly from the guidelines. Frequency of death, progression, loss of molecular response was not significantly increased during the pandemic era despite a few cases where the delay in assessment possibly played a role in the unfavorable outcomes. There were no COVID related deaths or disabilities. Conclusion The case-based untoward events would have probably been better managed with a more efficient communication web between patients, hematologists, and the laboratory. Therefore, it seems reasonable to consider whether such communicative paths are functional before giving up on the set schedule of CML management at times of uncertainty.
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Affiliation(s)
- Umut Yılmaz
- Division of Hematology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Selin Küçükyurt
- Division of Hematology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Sertaç Tunç
- Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Ahmet Emre Eşkazan
- Division of Hematology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
- *Correspondence: Ahmet Emre Eşkazan,
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Khaja M, Hayagreev V, Haider A, Ronderos D, Siddiqa A, Moirangthem V. Co-occurrence of CML Blast Crisis and Severe COVID 19 Infection: A Case Report. Cureus 2022; 14:e26865. [PMID: 35989789 PMCID: PMC9384850 DOI: 10.7759/cureus.26865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 11/05/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affecting multiple organ systems. It can cause severe cytokine storms leading to intensive care unit admission requiring mechanical ventilation. However, there have been few studies establishing the outcomes of chronic myeloid leukemia (CML) patients on tyrosine kinase inhibitors who are infected with COVID-19. We present a 69-year-old male with a history of CML on imatinib therapy with COVID-19 who developed acute respiratory distress syndrome needing mechanical ventilatory support, shock requiring vasopressors, and worse outcome secondary to blast crisis.
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Kim CS, Kim JY, Choi DR. COVID-19 pneumonia concurrent with newly diagnosed chronic myelogenous leukemia. Blood Res 2022; 57:74-75. [PMID: 35342044 PMCID: PMC8958368 DOI: 10.5045/br.2022.2021146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/19/2021] [Accepted: 12/24/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Chul Soo Kim
- Hematology and Oncology Service, Department of Internal Medicine, Sahmyook Medical Center, Seoul, Korea
| | - Jeong Yeon Kim
- Infectious Diseases Service, Department of Internal Medicine, Sahmyook Medical Center, Seoul, Korea
| | - Dae Ro Choi
- Hematology and Oncology Service, Department of Internal Medicine, Sahmyook Medical Center, Seoul, Korea
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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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Bonifacio M, Tiribelli M, Miggiano MC, Abruzzese E, Binotto G, Scaffidi L, Cordioli M, Damiani D, Di Bona E, Trawinska MM, Tanasi I, Dubbini MV, Velotta V, Ceccarelli G, Pierdomenico E, Lo Schirico M, Semenzato G, Ruggeri M, Fanin R, Tacconelli E, Pizzolo G, Krampera M. The serological prevalence of SARS-CoV-2 infection in patients with chronic myeloid leukemia is similar to that in the general population. Cancer Med 2021; 10:6310-6316. [PMID: 34464516 PMCID: PMC8446554 DOI: 10.1002/cam4.4179] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 06/30/2021] [Accepted: 07/28/2021] [Indexed: 12/18/2022] Open
Abstract
Background Patients with hematological malignancies are at an increased risk of SARS‐CoV‐2 disease (COVID‐19) and adverse outcome. However, a low mortality rate has been reported in patients with chronic myeloid leukemia (CML). Preclinical evidence suggests that tyrosine kinase inhibitors (TKIs) may have a protective role against severe COVID‐19. Methods We conducted a cross‐sectional study of 564 consecutive patients with CML who were tested for anti‐SARS‐CoV‐2 IgG/IgM antibodies at their first outpatient visit between May and early November 2020 in five hematologic centers representative of three Italian regions. Results The estimated serological prevalence of SARS‐CoV‐2 infection in patients with CML after the first pandemic wave was similar to that in the general population (about 2%), both at national and regional levels. CML patients with positive anti‐SARS‐CoV‐2 serology were more frequently male (p = 0.027) and active workers (p = 0.012), while there was no significant association with TKI treatment type. Only 3 out of 11 IgG‐positive patients had previously received a molecular diagnosis of COVID‐19, while the remainders were asymptomatic or with mild symptoms. Conclusions Our data confirm that the course of SARS‐CoV‐2 infection in patients with CML is generally mild and reassure about the safety of continuing TKIs during the COVID‐19 pandemic. Furthermore, we suggest that patients with CML succeed to mount an antibody response after exposure to SARS‐CoV‐2, similar to the general population.
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Affiliation(s)
| | - Mario Tiribelli
- Division of Hematology and BMT, Department of Medical Area, University of Udine, Udine, Italy
| | - Maria Cristina Miggiano
- Hematology Department, San Bortolo Hospital, Azienda ULSS8 "Berica" of Vicenza, Vicenza, Italy
| | | | - Gianni Binotto
- Padua School of Medicine, Department of Medicine, Hematology and Clinical Immunology, Padua, Italy
| | - Luigi Scaffidi
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Maddalena Cordioli
- Department of Diagnostics and Public Health, Section of Infectious Diseases, University of Verona, Verona, Italy
| | - Daniela Damiani
- Division of Hematology and BMT, Department of Medical Area, University of Udine, Udine, Italy
| | - Eros Di Bona
- Hematology Department, San Bortolo Hospital, Azienda ULSS8 "Berica" of Vicenza, Vicenza, Italy
| | | | - Ilaria Tanasi
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Maria Vittoria Dubbini
- Division of Hematology and BMT, Department of Medical Area, University of Udine, Udine, Italy
| | - Vanessa Velotta
- Hematology, S. Eugenio Hospital, ASL Roma2, Tor Vergata University, Rome, Italy
| | - Giulia Ceccarelli
- Hematology, S. Eugenio Hospital, ASL Roma2, Tor Vergata University, Rome, Italy
| | - Elisabetta Pierdomenico
- Padua School of Medicine, Department of Medicine, Hematology and Clinical Immunology, Padua, Italy
| | - Mariella Lo Schirico
- Padua School of Medicine, Department of Medicine, Hematology and Clinical Immunology, Padua, Italy
| | - Gianpietro Semenzato
- Padua School of Medicine, Department of Medicine, Hematology and Clinical Immunology, Padua, Italy
| | - Marco Ruggeri
- Hematology Department, San Bortolo Hospital, Azienda ULSS8 "Berica" of Vicenza, Vicenza, Italy
| | - Renato Fanin
- Division of Hematology and BMT, Department of Medical Area, University of Udine, Udine, Italy
| | - Evelina Tacconelli
- Department of Diagnostics and Public Health, Section of Infectious Diseases, University of Verona, Verona, Italy
| | - Giovanni Pizzolo
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Mauro Krampera
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
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Multiple cranial nerve palsies revealing blast crisis in patient with chronic myeloid leukemia in the accelerated phase under nilotinib during severe infection with SARS-COV-19 virus: Case report and review of literature. Radiol Case Rep 2021; 16:3602-3609. [PMID: 34422148 PMCID: PMC8367734 DOI: 10.1016/j.radcr.2021.08.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 08/11/2021] [Indexed: 11/30/2022] Open
Abstract
Since the introduction of tyrosine kinase inhibitors as primary therapy for patients with chronic myeloid leukemia (CML), the prognosis of these patients has improved significantly, and the number of patients who progress to the blast phase has decreased considerably. We report the case of a 35 year-old CML patient in accelerated phase treated with nilotinib, who presents a severe COVID-19 infection requiring non-invasive ventilation, and who subsequently presents a multiple cranial nerve palsy revealing a blast crisis of his CML. Multiple cranial nerve palsy is a sign of neurological involvement of CML in its blast phase. The blast crisis represents a real challenge for the clinician, especially during COVID-19 infection. The treatment remains the association of a tyrosine kinase inhibitors with a chemotherapy protocol, as well as the administration of methotrexate and cytarabine by intrathecal and intravenous infusion in high doses. Despite the importance of the association of CML with COVID-19 infection, there is not yet enough data to know the true impact of this infection on the evolution of this hemopathy.
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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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Nilotinib. REACTIONS WEEKLY 2021. [PMCID: PMC8103062 DOI: 10.1007/s40278-021-95610-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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