More complicated course of COVID-19 in leukaemia patients

SARS-CoV-2 infection has a more complicated course in leukaemia patients than in the general population and is accompanied by high viral titres in swaps and viraemia. Recent data suggests that reduced intensity therapy is warranted, especially in patients with acute myeloid leukaemia (AML) [1].

Dr Susanne Ghandili (University Medical Center Hamburg-Eppendorf, Germany) presented a series of 12 patients with acute leukaemia (median age 60 years, 25% women) and concomitant SARS-CoV-2 infection. Included were patients with newly diagnosed AML (n=3) or acute lymphoblastic leukaemia/lymphoblastic lymphoma (ALL/LBL; n=1) and patients who were already under leukaemia-specific treatment (AML n=5; ALL n=3).

Patients with leukaemia had a 7-fold higher rate of severe and critical courses compared with the general population. Three patients (25%) had mild or moderate courses of COVID-19 and 9 patients (75%) had severe and critical courses, including 2 deaths and 5 cases of severe acute respiratory distress syndrome (ARDS). Eleven patients (92%) developed COVID-19 pneumonia.

The 4 ALL patients received specific therapy with only small delays or modifications. The 3 patients with newly diagnosed AML developed critical courses with ARDS. Six patients received therapy with azacytidine and venetoclax for newly diagnosed or refractory AML. Only 2 participants required intubation and none died. This combination may be less toxic than intensive chemotherapy and may be used as a bridge to further therapy. Virological analyses highlight the importance of monitoring RNA load in plasma in critically ill COVID-19 patients.

1. Ghandili S, et al. Challenges in Treatment of Patients with Acute Leukemia and COVID-19 – a Series of 12 Patients. 62^nd ASH Annual Meeting, 5-8 December 2020. Abstract 1001.

Posted on 18 February 202119 November 2021