Treatment-Related Risk Factors for Adverse Outcomes of COVID-19 in Patients Treated for Lymphoid Malignancies in the Pre-Omicron Era—A Study of KroHem, the Croatian Group for Hematologic Diseases
Patients with lymphoid malignancies are at increased risk of death or prolonged infection due to COVID-19. Data on the influence of different antineoplastic treatment modalities on outcomes are conflicting. Anti-CD20 monoclonal antibodies increase the risk of prolonged infection. It is unclear wheth...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-01-01
|
| Series: | Biomedicines |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9059/12/2/331 |
| _version_ | 1827344061360504832 |
|---|---|
| author | Igor Aurer Ozren Jakšić Sandra Bašić-Kinda Stefan Mrđenović Slobodanka Ostojić-Kolonić Dominik Lozić Hrvoje Holik Sabina Novaković-Coha Petra Berneš Ivan Krečak Martina Morić-Perić Marino Narančić Zdravko Mitrović Toni Valković |
| author_facet | Igor Aurer Ozren Jakšić Sandra Bašić-Kinda Stefan Mrđenović Slobodanka Ostojić-Kolonić Dominik Lozić Hrvoje Holik Sabina Novaković-Coha Petra Berneš Ivan Krečak Martina Morić-Perić Marino Narančić Zdravko Mitrović Toni Valković |
| author_sort | Igor Aurer |
| collection | DOAJ |
| description | Patients with lymphoid malignancies are at increased risk of death or prolonged infection due to COVID-19. Data on the influence of different antineoplastic treatment modalities on outcomes are conflicting. Anti-CD20 monoclonal antibodies increase the risk of prolonged infection. It is unclear whether this risk is affected by the choice of the antibody (rituximab vs. obinutuzumab). To elucidate the role of antineoplastic therapy on COVID-19 outcomes, KroHem collected data on patients with lymphoid malignancies diagnosed with COVID-19 between October 2020 and April 2021. A total of 314 patients were identified, 75 untreated, 61 off treatment and 178 on treatment. The mortality rate in untreated and off-treatment patients was 15% and 16%; 9% and 10% had prolonged infection. In the on-treatment group, 3% were still prolonged positive at time of data collection, 62% recovered and 35% died; 42% had prolonged infection. Disease type, use of anti-CD20 monoclonal antibodies, prior autologous stem-cell transplantation (ASCT) and line of treatment did not significantly affect mortality. Mortality was higher in older patients (<i>p</i> = 0.0078) and those treated with purine analogues (<i>p</i> = 0.012). Prolonged COVID-19 was significantly more frequent in patients treated with anti-CD20 monoclonal antibodies (<i>p</i> = 0.012), especially obinutuzumab, and purine analogues (<i>p</i> = 0.012). Age, prior ASCT and treatment line did not significantly affect risk of prolonged infection. These data suggest that increased age and use of purine analogues are main risk factors for increased mortality of COVID-19 in patients with lymphoid malignancies. Obinutuzumab further increases the risk of prolonged disease, but not of death, in comparison to rituximab. Epidemiological considerations should be taken into account when choosing the appropriate antineoplastic therapy for patients with lymphoid malignancies. |
| first_indexed | 2024-03-07T22:41:33Z |
| format | Article |
| id | doaj.art-4511e1e613e74b6983e3aef21eb96186 |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-07T22:41:33Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-4511e1e613e74b6983e3aef21eb961862024-02-23T15:08:30ZengMDPI AGBiomedicines2227-90592024-01-0112233110.3390/biomedicines12020331Treatment-Related Risk Factors for Adverse Outcomes of COVID-19 in Patients Treated for Lymphoid Malignancies in the Pre-Omicron Era—A Study of KroHem, the Croatian Group for Hematologic DiseasesIgor Aurer0Ozren Jakšić1Sandra Bašić-Kinda2Stefan Mrđenović3Slobodanka Ostojić-Kolonić4Dominik Lozić5Hrvoje Holik6Sabina Novaković-Coha7Petra Berneš8Ivan Krečak9Martina Morić-Perić10Marino Narančić11Zdravko Mitrović12Toni Valković13University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, CroatiaSchool of Medicine, University of Zagreb, Šalata 3, 10000 Zagreb, CroatiaUniversity Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, CroatiaUniversity Hospital Centre Osijek, J. Huttlera 4, 31000 Osijek, CroatiaSchool of Medicine, University of Zagreb, Šalata 3, 10000 Zagreb, CroatiaUniversity Hospital Centre Split, Spinčićeva 1, 21000 Split, CroatiaGeneral Hospital Dr. Josip Benčević, A. Štampara 42, 35000 Slavonski Brod, CroatiaUniversity Hospital Centre Sisters of Mercy, Vinogradska c. 29, 10000 Zagreb, CroatiaGeneral Hospital Pula, Santoriova ul. 24a, 52100 Pula, CroatiaGeneral Hospital Šibenik, S. Radića 83, 22000 Šibenik, CroatiaGeneral Hospital Zadar, B. Peričića 5, 23000 Zadar, CroatiaGeneral Hospital Zadar, B. Peričića 5, 23000 Zadar, CroatiaSchool of Medicine, University of Zagreb, Šalata 3, 10000 Zagreb, CroatiaFaculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, CroatiaPatients with lymphoid malignancies are at increased risk of death or prolonged infection due to COVID-19. Data on the influence of different antineoplastic treatment modalities on outcomes are conflicting. Anti-CD20 monoclonal antibodies increase the risk of prolonged infection. It is unclear whether this risk is affected by the choice of the antibody (rituximab vs. obinutuzumab). To elucidate the role of antineoplastic therapy on COVID-19 outcomes, KroHem collected data on patients with lymphoid malignancies diagnosed with COVID-19 between October 2020 and April 2021. A total of 314 patients were identified, 75 untreated, 61 off treatment and 178 on treatment. The mortality rate in untreated and off-treatment patients was 15% and 16%; 9% and 10% had prolonged infection. In the on-treatment group, 3% were still prolonged positive at time of data collection, 62% recovered and 35% died; 42% had prolonged infection. Disease type, use of anti-CD20 monoclonal antibodies, prior autologous stem-cell transplantation (ASCT) and line of treatment did not significantly affect mortality. Mortality was higher in older patients (<i>p</i> = 0.0078) and those treated with purine analogues (<i>p</i> = 0.012). Prolonged COVID-19 was significantly more frequent in patients treated with anti-CD20 monoclonal antibodies (<i>p</i> = 0.012), especially obinutuzumab, and purine analogues (<i>p</i> = 0.012). Age, prior ASCT and treatment line did not significantly affect risk of prolonged infection. These data suggest that increased age and use of purine analogues are main risk factors for increased mortality of COVID-19 in patients with lymphoid malignancies. Obinutuzumab further increases the risk of prolonged disease, but not of death, in comparison to rituximab. Epidemiological considerations should be taken into account when choosing the appropriate antineoplastic therapy for patients with lymphoid malignancies.https://www.mdpi.com/2227-9059/12/2/331lymphomachronic lymphocytic leukemiaCOVID-19rituximabobinutuzumabpurine analogues |
| spellingShingle | Igor Aurer Ozren Jakšić Sandra Bašić-Kinda Stefan Mrđenović Slobodanka Ostojić-Kolonić Dominik Lozić Hrvoje Holik Sabina Novaković-Coha Petra Berneš Ivan Krečak Martina Morić-Perić Marino Narančić Zdravko Mitrović Toni Valković Treatment-Related Risk Factors for Adverse Outcomes of COVID-19 in Patients Treated for Lymphoid Malignancies in the Pre-Omicron Era—A Study of KroHem, the Croatian Group for Hematologic Diseases Biomedicines lymphoma chronic lymphocytic leukemia COVID-19 rituximab obinutuzumab purine analogues |
| title | Treatment-Related Risk Factors for Adverse Outcomes of COVID-19 in Patients Treated for Lymphoid Malignancies in the Pre-Omicron Era—A Study of KroHem, the Croatian Group for Hematologic Diseases |
| title_full | Treatment-Related Risk Factors for Adverse Outcomes of COVID-19 in Patients Treated for Lymphoid Malignancies in the Pre-Omicron Era—A Study of KroHem, the Croatian Group for Hematologic Diseases |
| title_fullStr | Treatment-Related Risk Factors for Adverse Outcomes of COVID-19 in Patients Treated for Lymphoid Malignancies in the Pre-Omicron Era—A Study of KroHem, the Croatian Group for Hematologic Diseases |
| title_full_unstemmed | Treatment-Related Risk Factors for Adverse Outcomes of COVID-19 in Patients Treated for Lymphoid Malignancies in the Pre-Omicron Era—A Study of KroHem, the Croatian Group for Hematologic Diseases |
| title_short | Treatment-Related Risk Factors for Adverse Outcomes of COVID-19 in Patients Treated for Lymphoid Malignancies in the Pre-Omicron Era—A Study of KroHem, the Croatian Group for Hematologic Diseases |
| title_sort | treatment related risk factors for adverse outcomes of covid 19 in patients treated for lymphoid malignancies in the pre omicron era a study of krohem the croatian group for hematologic diseases |
| topic | lymphoma chronic lymphocytic leukemia COVID-19 rituximab obinutuzumab purine analogues |
| url | https://www.mdpi.com/2227-9059/12/2/331 |
| work_keys_str_mv | AT igoraurer treatmentrelatedriskfactorsforadverseoutcomesofcovid19inpatientstreatedforlymphoidmalignanciesinthepreomicroneraastudyofkrohemthecroatiangroupforhematologicdiseases AT ozrenjaksic treatmentrelatedriskfactorsforadverseoutcomesofcovid19inpatientstreatedforlymphoidmalignanciesinthepreomicroneraastudyofkrohemthecroatiangroupforhematologicdiseases AT sandrabasickinda treatmentrelatedriskfactorsforadverseoutcomesofcovid19inpatientstreatedforlymphoidmalignanciesinthepreomicroneraastudyofkrohemthecroatiangroupforhematologicdiseases AT stefanmrđenovic treatmentrelatedriskfactorsforadverseoutcomesofcovid19inpatientstreatedforlymphoidmalignanciesinthepreomicroneraastudyofkrohemthecroatiangroupforhematologicdiseases AT slobodankaostojickolonic treatmentrelatedriskfactorsforadverseoutcomesofcovid19inpatientstreatedforlymphoidmalignanciesinthepreomicroneraastudyofkrohemthecroatiangroupforhematologicdiseases AT dominiklozic treatmentrelatedriskfactorsforadverseoutcomesofcovid19inpatientstreatedforlymphoidmalignanciesinthepreomicroneraastudyofkrohemthecroatiangroupforhematologicdiseases AT hrvojeholik treatmentrelatedriskfactorsforadverseoutcomesofcovid19inpatientstreatedforlymphoidmalignanciesinthepreomicroneraastudyofkrohemthecroatiangroupforhematologicdiseases AT sabinanovakoviccoha treatmentrelatedriskfactorsforadverseoutcomesofcovid19inpatientstreatedforlymphoidmalignanciesinthepreomicroneraastudyofkrohemthecroatiangroupforhematologicdiseases AT petrabernes treatmentrelatedriskfactorsforadverseoutcomesofcovid19inpatientstreatedforlymphoidmalignanciesinthepreomicroneraastudyofkrohemthecroatiangroupforhematologicdiseases AT ivankrecak treatmentrelatedriskfactorsforadverseoutcomesofcovid19inpatientstreatedforlymphoidmalignanciesinthepreomicroneraastudyofkrohemthecroatiangroupforhematologicdiseases AT martinamoricperic treatmentrelatedriskfactorsforadverseoutcomesofcovid19inpatientstreatedforlymphoidmalignanciesinthepreomicroneraastudyofkrohemthecroatiangroupforhematologicdiseases AT marinonarancic treatmentrelatedriskfactorsforadverseoutcomesofcovid19inpatientstreatedforlymphoidmalignanciesinthepreomicroneraastudyofkrohemthecroatiangroupforhematologicdiseases AT zdravkomitrovic treatmentrelatedriskfactorsforadverseoutcomesofcovid19inpatientstreatedforlymphoidmalignanciesinthepreomicroneraastudyofkrohemthecroatiangroupforhematologicdiseases AT tonivalkovic treatmentrelatedriskfactorsforadverseoutcomesofcovid19inpatientstreatedforlymphoidmalignanciesinthepreomicroneraastudyofkrohemthecroatiangroupforhematologicdiseases |