Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry study
Abstract Background Patients with cancer have been shown to have a higher risk of clinical severity and mortality compared to non-cancer patients with COVID-19. Patients with hematologic malignancies typically are known to have higher levels of immunosuppression and may develop more severe respirato...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-10-01
|
| Series: | Journal of Hematology & Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13045-020-00970-7 |
| _version_ | 1818384689893736448 |
|---|---|
| author | Julio García-Suárez Javier de la Cruz Ángel Cedillo Pilar Llamas Rafael Duarte Víctor Jiménez-Yuste José Ángel Hernández-Rivas Rodrigo Gil-Manso Mi Kwon Pedro Sánchez-Godoy Pilar Martínez-Barranco Blanca Colás-Lahuerta Pilar Herrera Laurentino Benito-Parra Adrián Alegre Alberto Velasco Arturo Matilla María Concepción Aláez-Usón Rafael Martos-Martínez Carmen Martínez-Chamorro Keina Susana-Quiroz Juan Francisco Del Campo Adolfo de la Fuente Regina Herráez Adriana Pascual Elvira Gómez Jaime Pérez-Oteyza Elena Ruiz Arancha Alonso José González-Medina Lucía Núñez Martín-Buitrago Miguel Canales Isabel González-Gascón María Carmen Vicente-Ayuso Susana Valenciano María García Roa Pablo Estival Monteliu Javier López-Jiménez Cristián Escolano Escobar Javier Ortiz-Martín José Luis Diez-Martin Joaquín Martinez-Lopez the Asociación Madrileña de Hematología y Hemoterapia (AMHH) |
| author_facet | Julio García-Suárez Javier de la Cruz Ángel Cedillo Pilar Llamas Rafael Duarte Víctor Jiménez-Yuste José Ángel Hernández-Rivas Rodrigo Gil-Manso Mi Kwon Pedro Sánchez-Godoy Pilar Martínez-Barranco Blanca Colás-Lahuerta Pilar Herrera Laurentino Benito-Parra Adrián Alegre Alberto Velasco Arturo Matilla María Concepción Aláez-Usón Rafael Martos-Martínez Carmen Martínez-Chamorro Keina Susana-Quiroz Juan Francisco Del Campo Adolfo de la Fuente Regina Herráez Adriana Pascual Elvira Gómez Jaime Pérez-Oteyza Elena Ruiz Arancha Alonso José González-Medina Lucía Núñez Martín-Buitrago Miguel Canales Isabel González-Gascón María Carmen Vicente-Ayuso Susana Valenciano María García Roa Pablo Estival Monteliu Javier López-Jiménez Cristián Escolano Escobar Javier Ortiz-Martín José Luis Diez-Martin Joaquín Martinez-Lopez the Asociación Madrileña de Hematología y Hemoterapia (AMHH) |
| author_sort | Julio García-Suárez |
| collection | DOAJ |
| description | Abstract Background Patients with cancer have been shown to have a higher risk of clinical severity and mortality compared to non-cancer patients with COVID-19. Patients with hematologic malignancies typically are known to have higher levels of immunosuppression and may develop more severe respiratory viral infections than patients with solid tumors. Data on COVID-19 in patients with hematologic malignancies are limited. Here we characterize disease severity and mortality and evaluate potential prognostic factors for mortality. Methods In this population-based registry study, we collected de-identified data on clinical characteristics, treatment and outcomes in adult patients with hematologic malignancies and confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection within the Madrid region of Spain. Our case series included all patients admitted to 22 regional health service hospitals and 5 private healthcare centers between February 28 and May 25, 2020. The primary study outcome was all-cause mortality. We assessed the association between mortality and potential prognostic factors using Cox regression analyses adjusted for age, sex, comorbidities, hematologic malignancy and recent active cancer therapy. Results Of 833 patients reported, 697 were included in the analyses. Median age was 72 years (IQR 60–79), 413 (60%) patients were male and 479 (69%) and 218 (31%) had lymphoid and myeloid malignancies, respectively. Clinical severity of COVID-19 was severe/critical in 429 (62%) patients. At data cutoff, 230 (33%) patients had died. Age ≥ 60 years (hazard ratios 3.17–10.1 vs < 50 years), > 2 comorbidities (1.41 vs ≤ 2), acute myeloid leukemia (2.22 vs non-Hodgkin lymphoma) and active antineoplastic treatment with monoclonal antibodies (2·02) were associated with increased mortality; conventional chemotherapy showed borderline significance (1.50 vs no active therapy). Conversely, Ph-negative myeloproliferative neoplasms (0.33) and active treatment with hypomethylating agents (0.47) were associated with lower mortality. Overall, 574 (82%) patients received antiviral therapy. Mortality with severe/critical COVID-19 was higher with no therapy vs any antiviral combination therapy (2.20). Conclusions In this series of patients with hematologic malignancies and COVID-19, mortality was associated with higher age, more comorbidities, type of hematological malignancy and type of antineoplastic therapy. Further studies and long-term follow-up are required to validate these criteria for risk stratification. |
| first_indexed | 2024-12-14T03:26:16Z |
| format | Article |
| id | doaj.art-a3adfa6f2a6e43bc89a85fd388a33caa |
| institution | Directory Open Access Journal |
| issn | 1756-8722 |
| language | English |
| last_indexed | 2024-12-14T03:26:16Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Hematology & Oncology |
| spelling | doaj.art-a3adfa6f2a6e43bc89a85fd388a33caa2022-12-21T23:18:52ZengBMCJournal of Hematology & Oncology1756-87222020-10-0113111210.1186/s13045-020-00970-7Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry studyJulio García-Suárez0Javier de la Cruz1Ángel Cedillo2Pilar Llamas3Rafael Duarte4Víctor Jiménez-Yuste5José Ángel Hernández-Rivas6Rodrigo Gil-Manso7Mi Kwon8Pedro Sánchez-Godoy9Pilar Martínez-Barranco10Blanca Colás-Lahuerta11Pilar Herrera12Laurentino Benito-Parra13Adrián Alegre14Alberto Velasco15Arturo Matilla16María Concepción Aláez-Usón17Rafael Martos-Martínez18Carmen Martínez-Chamorro19Keina Susana-Quiroz20Juan Francisco Del Campo21Adolfo de la Fuente22Regina Herráez23Adriana Pascual24Elvira Gómez25Jaime Pérez-Oteyza26Elena Ruiz27Arancha Alonso28José González-Medina29Lucía Núñez Martín-Buitrago30Miguel Canales31Isabel González-Gascón32María Carmen Vicente-Ayuso33Susana Valenciano34María García Roa35Pablo Estival Monteliu36Javier López-Jiménez37Cristián Escolano Escobar38Javier Ortiz-Martín39José Luis Diez-Martin40Joaquín Martinez-Lopez41the Asociación Madrileña de Hematología y Hemoterapia (AMHH)Hematology Department, University Hospital Príncipe de AsturiasResearch Institute imas12, University Hospital, SAMID-ISCIIIAsociación Madrileña de Hematología Y Hemoterapia (AMHH)Hematology Department, University Hospital Fundación Jiménez DíazHematology Department, University Hospital Puerta de Hierro MajadahondaHematology Department, University Hospital La PazHematology Department, University Hospital Infanta LeonorHematology Department, CNIO-ISCIII, CIBERONC, Complutense UniversityHematology Department, University General Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio MarañónHematology Department, University Hospital Severo OchoaHematology Department, University Hospital Fundación AlcorcónHematology Department, University Hospital Clínico San CarlosHematology Department, University Hospital Ramón Y CajalHematology Department, University Hospital GetafeHematology Department, University Hospital La PrincesaHematology Department, University Hospital Rey Juan CarlosHematology Department, University Hospital Central de La Defensa Gómez UllaHematology Department, University Hospital HLA MoncloaHematology Department, University Hospital VillalbaHematology Department, University Hospital QuirónsaludHematology Department, University Hospital MóstolesHematology Department, University Hospital HenaresHematology Department, MD Anderson Cancer Center MadridHematology Department, University Hospital Infanta SofíaHematology Department, University Hospital Infanta ElenaHematology Department, University Hospital SuresteHematology Department, University Hospital HM SanchinarroHematology Department, University Hospital TajoHematology Department, Hospital RuberHematology Department, University Hospital Fundación Jiménez DíazHematology Department, University Hospital Puerta de Hierro MajadahondaHematology Department, University Hospital La PazHematology Department, University Hospital Infanta LeonorHematology Department, University Hospital Severo OchoaHematology Department, University Hospital Príncipe de AsturiasHematology Department, University Hospital Fundación AlcorcónHematology Department, University Hospital Clínico San CarlosHematology Department, University Hospital Ramón Y CajalHematology Department, University Hospital GetafeHematology Department, University Hospital La PrincesaHematology Department, University General Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio MarañónHematology Department, CNIO-ISCIII, CIBERONC, Complutense UniversityAbstract Background Patients with cancer have been shown to have a higher risk of clinical severity and mortality compared to non-cancer patients with COVID-19. Patients with hematologic malignancies typically are known to have higher levels of immunosuppression and may develop more severe respiratory viral infections than patients with solid tumors. Data on COVID-19 in patients with hematologic malignancies are limited. Here we characterize disease severity and mortality and evaluate potential prognostic factors for mortality. Methods In this population-based registry study, we collected de-identified data on clinical characteristics, treatment and outcomes in adult patients with hematologic malignancies and confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection within the Madrid region of Spain. Our case series included all patients admitted to 22 regional health service hospitals and 5 private healthcare centers between February 28 and May 25, 2020. The primary study outcome was all-cause mortality. We assessed the association between mortality and potential prognostic factors using Cox regression analyses adjusted for age, sex, comorbidities, hematologic malignancy and recent active cancer therapy. Results Of 833 patients reported, 697 were included in the analyses. Median age was 72 years (IQR 60–79), 413 (60%) patients were male and 479 (69%) and 218 (31%) had lymphoid and myeloid malignancies, respectively. Clinical severity of COVID-19 was severe/critical in 429 (62%) patients. At data cutoff, 230 (33%) patients had died. Age ≥ 60 years (hazard ratios 3.17–10.1 vs < 50 years), > 2 comorbidities (1.41 vs ≤ 2), acute myeloid leukemia (2.22 vs non-Hodgkin lymphoma) and active antineoplastic treatment with monoclonal antibodies (2·02) were associated with increased mortality; conventional chemotherapy showed borderline significance (1.50 vs no active therapy). Conversely, Ph-negative myeloproliferative neoplasms (0.33) and active treatment with hypomethylating agents (0.47) were associated with lower mortality. Overall, 574 (82%) patients received antiviral therapy. Mortality with severe/critical COVID-19 was higher with no therapy vs any antiviral combination therapy (2.20). Conclusions In this series of patients with hematologic malignancies and COVID-19, mortality was associated with higher age, more comorbidities, type of hematological malignancy and type of antineoplastic therapy. Further studies and long-term follow-up are required to validate these criteria for risk stratification.http://link.springer.com/article/10.1186/s13045-020-00970-7Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)COVID-19Hematologic neoplasms |
| spellingShingle | Julio García-Suárez Javier de la Cruz Ángel Cedillo Pilar Llamas Rafael Duarte Víctor Jiménez-Yuste José Ángel Hernández-Rivas Rodrigo Gil-Manso Mi Kwon Pedro Sánchez-Godoy Pilar Martínez-Barranco Blanca Colás-Lahuerta Pilar Herrera Laurentino Benito-Parra Adrián Alegre Alberto Velasco Arturo Matilla María Concepción Aláez-Usón Rafael Martos-Martínez Carmen Martínez-Chamorro Keina Susana-Quiroz Juan Francisco Del Campo Adolfo de la Fuente Regina Herráez Adriana Pascual Elvira Gómez Jaime Pérez-Oteyza Elena Ruiz Arancha Alonso José González-Medina Lucía Núñez Martín-Buitrago Miguel Canales Isabel González-Gascón María Carmen Vicente-Ayuso Susana Valenciano María García Roa Pablo Estival Monteliu Javier López-Jiménez Cristián Escolano Escobar Javier Ortiz-Martín José Luis Diez-Martin Joaquín Martinez-Lopez the Asociación Madrileña de Hematología y Hemoterapia (AMHH) Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry study Journal of Hematology & Oncology Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) COVID-19 Hematologic neoplasms |
| title | Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry study |
| title_full | Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry study |
| title_fullStr | Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry study |
| title_full_unstemmed | Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry study |
| title_short | Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry study |
| title_sort | impact of hematologic malignancy and type of cancer therapy on covid 19 severity and mortality lessons from a large population based registry study |
| topic | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) COVID-19 Hematologic neoplasms |
| url | http://link.springer.com/article/10.1186/s13045-020-00970-7 |
| work_keys_str_mv | AT juliogarciasuarez impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT javierdelacruz impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT angelcedillo impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT pilarllamas impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT rafaelduarte impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT victorjimenezyuste impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT joseangelhernandezrivas impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT rodrigogilmanso impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT mikwon impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT pedrosanchezgodoy impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT pilarmartinezbarranco impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT blancacolaslahuerta impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT pilarherrera impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT laurentinobenitoparra impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT adrianalegre impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT albertovelasco impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT arturomatilla impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT mariaconcepcionalaezuson impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT rafaelmartosmartinez impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT carmenmartinezchamorro impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT keinasusanaquiroz impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT juanfranciscodelcampo impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT adolfodelafuente impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT reginaherraez impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT adrianapascual impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT elviragomez impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT jaimeperezoteyza impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT elenaruiz impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT aranchaalonso impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT josegonzalezmedina impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT lucianunezmartinbuitrago impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT miguelcanales impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT isabelgonzalezgascon impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT mariacarmenvicenteayuso impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT susanavalenciano impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT mariagarciaroa impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT pabloestivalmonteliu impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT javierlopezjimenez impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT cristianescolanoescobar impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT javierortizmartin impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT joseluisdiezmartin impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT joaquinmartinezlopez impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy AT theasociacionmadrilenadehematologiayhemoterapiaamhh impactofhematologicmalignancyandtypeofcancertherapyoncovid19severityandmortalitylessonsfromalargepopulationbasedregistrystudy |