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Lamure S, Duléry R, Di Blasi R, Chauchet A, Laureana C, Deau-Fischer B, Drenou B, Soussain C, Rossi C, Noël N, Choquet S, Bologna S, Joly B, Kohn M, Malak S, Fouquet G, Daguindau E, Bernard S, Thiéblemont C, Cartron G, Lacombe K, Besson C. Determinants of outcome in Covid-19 hospitalized patients with lymphoma: A retrospective multicentric cohort study. EClinicalMedicine 2020; 27:100549. [PMID: 33073216 PMCID: PMC7550257 DOI: 10.1016/j.eclinm.2020.100549] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/29/2020] [Accepted: 09/03/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patients with lymphoma are immunocompromised because of the disease per se and its treatments. We aimed to describe the characteristics of patients with lymphoma hospitalized for Coronavirus Disease 2019 (Covid-19) and to analyze pre-Covid-19 determinants of mortality. METHODS This retrospective multicentric cohort study used the Programme de Médicalisation des Systèmes d'Information database to identify all adult patients with lymphoma, hospitalized for Covid-19 in March and April 2020, in 12 hospitals of three French regions with pandemic outbreaks. The characteristics of lymphoma and Covid-19 were collected from medical charts. FINDINGS Eighty-nine patients were included. The median age was 67 years (range, 19-92), 66% were male and 72% had a comorbidity. Most patients had B-cell non-Hodgkin lymphoma (86%) and had received a lymphoma treatment within one year (70%). With a median follow-up of 33 days from admission, 30-day overall survival was 71%, (95% confidence interval, 62-81%). In multivariable analysis, having an age ≥ 70 years (hazard ratio 2·87, 1·20-6·85, p = 0·02) and relapsed/refractory lymphoma (hazard ratio 2·54, 1·14-5·66, p = 0·02) were associated with mortality. Recent bendamustine treatment (n = 9) was also pejorative (hazard ratio 3·20, 1·33-7·72, p = 0·01), but was strongly associated with relapsed/refractory lymphoma. Remarkably, 30-day overall survival for patients < 70 years of age without relapsed/refractory lymphoma was 88% (78% - 99%). INTERPRETATION Thirty-day mortality was associated with being older and relapsed/refractory lymphoma. Survival of patients younger than 70 years without relapsed/refractory lymphoma was comparable to that of the general population. FUNDING There have been no specific funds to run this study.
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Affiliation(s)
- Sylvain Lamure
- Département d'Hématologie Clinique, CHU de Montpellier, UMR-CNRS 5535, Université de Montpellier, Montpellier, France
| | - Rémy Duléry
- Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, Assistance Publique - Hôpitaux de Paris, Inserm UMRs 938, Sorbonne Université, Paris, France
| | - Roberta Di Blasi
- Service d'Hématologie-Oncologie, Hôpital St Louis, Assistance Publique - Hôpitaux de Paris ; Université de Paris – Diderot, Paris, France
| | | | - Cécile Laureana
- Service d'Hématologie Oncologie, Centre Hospitalier de Versailles, 177, rue de Versailles, 78157 Le Chesnay Cedex, France
| | - Bénédicte Deau-Fischer
- Service d'Hématologie Clinique, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Bernard Drenou
- Département d'Hématologie Groupe Hospitalier de Mulhouse Sud Alsace, Mulhouse, France
| | - Carole Soussain
- Département d'Oncologie médicale – Hématologie, Institut Curie, Saint Cloud, France
| | - Cédric Rossi
- Service d'Hématologie Clinique, CHU de Dijon Bourgogne, Dijon, France
| | - Nicolas Noël
- Service de Médecine Interne – Immunologie, Hôpital Bicêtre, Assistance Publique - Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Sylvain Choquet
- Service d'Hématologie Clinique, Hôpital Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Serge Bologna
- Service d'Hématologie, Centre d'Oncologie de Gentilly, Nancy, France
| | - Bertrand Joly
- Service d'Hématologie, Centre Hospitalier Sud Francilien, Corbeil-Essonnes, France
| | - Milena Kohn
- Service d'Hématologie Oncologie, Centre Hospitalier de Versailles, 177, rue de Versailles, 78157 Le Chesnay Cedex, France
| | - Sandra Malak
- Département d'Oncologie médicale – Hématologie, Institut Curie, Saint Cloud, France
| | - Guillemette Fouquet
- Service d'Hématologie Clinique, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France
| | | | - Sophie Bernard
- Service d'Hématologie-Oncologie, Hôpital St Louis, Assistance Publique - Hôpitaux de Paris ; Université de Paris – Diderot, Paris, France
| | - Catherine Thiéblemont
- Service d'Hématologie-Oncologie, Hôpital St Louis, Assistance Publique - Hôpitaux de Paris ; Université de Paris – Diderot, Paris, France
| | - Guillaume Cartron
- Département d'Hématologie Clinique, CHU de Montpellier, UMR-CNRS 5535, Université de Montpellier, Montpellier, France
| | - Karine Lacombe
- Sorbonne Université, Inserm IPLESP, Service des Maladies Infectieuses et Tropicales, Hôpital Saint Antoine, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Caroline Besson
- Service d'Hématologie Oncologie, Centre Hospitalier de Versailles, 177, rue de Versailles, 78157 Le Chesnay Cedex, France
- Université Paris-Saclay, UVSQ, Montigny le Bretonneux; Inserm U1018, CESP, Villejuif, France
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