: 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.
Marchesi, F., Salmanton-García, J., Emarah, Z., Piukovics, K., Nucci, M., López-García, A., Ráčil, Z., Farina, F., Popova, M., Zompi, S., Audisio, E., Ledoux, M., Verga, L., Weinbergerová, B., Szotkovski, T., Da Silva, M. G., Fracchiolla, N., De Jonge, N., Collins, G., Marchetti, M., Magliano, G., García-Vidal, C., Biernat, M. M., Van Doesum, J., Machado, M., Demirkan, F., Al-Khabori, M., Žák, P., Víšek, B., Stoma, I., Méndez, G., Maertens, J., Khanna, N., Espigado, I., Dragonetti, G., Fianchi, L., Del Principe, M. I., Cabirta, A., Ormazabal-Vélez, I., Jaksic, O., Buquicchio, C., Bonuomo, V., Batinić, J., Omrani, A. S., Lamure, S., Finizio, O., Fernández, N., Falces-Romero, I., Blennow, O., Bergantim, R., Ali, N., Win, S., Van Praet, J., Tisi, M. C., 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, N. C., El-Ashwah, S., Cordoba, R., Hanakova, M., Zambrotta, G., Sciumè, M., Booth, S., Rodrigues, R. N., Sacchi, M. V., García-Poutón, N., Martín-González, J., Khostelidi, S., Gräfe, S., Rahimli, L., Ammatuna, E., Busca, A., Corradini, P., Hoenigl, M., Klimko, N., Koehler, P., Pagliuca, A., Passamonti, F., Cornely, O. A., Pagano, L., COVID-19 in adult acute myeloid leukemia patients: a long-term follow-up study from the European Hematology Association survey (EPICOVIDEHA), <<HAEMATOLOGICA>>, 2023; 108 (1): 22-33. [doi:10.3324/haematol.2022.280847] [https://hdl.handle.net/10807/223850]
COVID-19 in adult acute myeloid leukemia patients: a long-term follow-up study from the European Hematology Association survey (EPICOVIDEHA)
Dragonetti, GiuliaMembro del Collaboration Group
;Fianchi, LuanaMembro del Collaboration Group
;Pagano, LivioWriting – Review & Editing
2023
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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