TY - JOUR
T1 - Outcomes of COVID-19 in patients with CLL
T2 - a multicenter international experience
AU - Mato, Anthony R.
AU - Roeker, Lindsey E.
AU - Lamanna, Nicole
AU - Allan, John N.
AU - Leslie, Lori
AU - Pagel, John M.
AU - Patel, Krish
AU - Osterborg, Anders
AU - Wojenski, Daniel
AU - Kamdar, Manali
AU - Huntington, Scott F.
AU - Davids, Matthew S.
AU - Brown, Jennifer R.
AU - Antic, Darko
AU - Jacobs, Ryan
AU - Ahn, Inhye E.
AU - Pu, Jeffrey
AU - Isaac, Krista M.
AU - Barr, Paul M.
AU - Ujjani, Chaitra S.
AU - Geyer, Mark B.
AU - Berman, Ellin
AU - Zelenetz, Andrew D.
AU - Malakhov, Nikita
AU - Furman, Richard R.
AU - Koropsak, Michael
AU - Bailey, Neil
AU - Hanson, Lotta
AU - Perini, Guilherme F.
AU - Ma, Shuo
AU - Ryan, Christine E.
AU - Wiestner, Adrian
AU - Portell, Craig A.
AU - Shadman, Mazyar
AU - Chong, Elise A.
AU - Brander, Danielle M.
AU - Sundaram, Suchitra
AU - Seddon, Amanda N.
AU - Seymour, Erlene
AU - Patel, Meera
AU - Martinez-Calle, Nicolas
AU - Munir, Talha
AU - Walewska, Renata
AU - Broom, Angus
AU - Walter, Harriet
AU - El-Sharkawi, Dima
AU - Parry, Helen
AU - Wilson, Matthew R.
AU - Patten, Piers E.M.
AU - Hernández-Rivas, José Ángel
AU - Miras, Fatima
AU - Escalada, Noemi Fernández
AU - Ghione, Paola
AU - Nabhan, Chadi
AU - Lebowitz, Sonia
AU - Bhavsar, Erica
AU - López-Jiménez, Javier
AU - Naya, Daniel
AU - Garcia-Marco, Jose Antonio
AU - Skånland, Sigrid S.
AU - Cordoba, Raul
AU - Eyre, Toby A.
N1 - Funding Information:
This research was supported in part by the National Institutes of Health/ National Cancer Institute (Cancer Center Support Grant P30 CA008748). L.E.R. recognizes support from the American Society of Hematology Research Training Award for Fellows outside of the submitted work. I.E.A. receives research support from the Intramural Program of the National Heart, Lung, and Blood Institute and an American Society of Hematology Scholar Award. T.A.E. recognizes support from the Oxford NIHR Biomedical Research Centre.
Funding Information:
Conflict-of-interest disclosure: A.R.M. received grants, personal fees, DSMB membership, and other funds from TG Therapeutics; grants and personal fees from Pharmacyclics, Janssen, Genentch, AbbVie, Adaptive, and Astra Zeneca; grants and other funds from Celgene; grants from Loxo, Sunesis, Regeneron, and DTRM Biopharm; and personal fees from BeiGene. L.E.R. received grant support from the American Society of Hematology and has minority ownership interest in AbbVie and Abbott Laboratories. J.N.A. received advisory/consulting fees from AbbVie, Pharmacyclics, Janssen, AstraZeneca, and Genentech and honoraria and nonpromotional speaking fees from Janssen, AbbVie, and Pharmacyclics. L.L. received speakers bureau fees from Seattle Genetics, Celgene/BMS, KitePharma, BeiGene, Pharmacyclics/Janssen, and AstraZeneca and advisory board participation fees from Bayer, Seattle Genetics, ADC Therapeutics, AbbVie, Janssen, Pharmacyclics, KitePharma, and Astra-Zeneca. A.O. received grants for academic research from BeiGene and Kancera, has stock ownership in Kancera, and received consultancy fees from Sanofi. S.F.H. is a consultant for Celgene, Bayer, Genentech, Pharmacyclics, Novartis, and AbbVie and received research funding from DTRM Biopharm, Celgene, and TG Therapeutics. M.S.D. received grants from Ascentage Pharma, AstraZeneca, BMS, Genentech, MEI Pharma, Pharmacyclics, Surface Oncology, TG Therapeutics and Verastem, and consulting fees from AbbVie, Adaptive Biotechnologies, Ascentage Pharma, AstraZeneca, BeiGene, Celgene, Genentech, Gilead Sciences, Janssen, MEI Pharma, Pharmacyclics, Syros Pharmaceuticals, TG Therapeutics, Verastem, and Zentalis. J.R.B. has served as a consultant for AbbVie, Acerta, AstraZeneca, BeiGene, Catapult, Dynamo Therapeutics, Juno/Celgene, KitePharma, MEI Pharma, Nextcea, Novartis, Octa-pharma, Pfizer, Sunesis, TG Therapeutics, and Verastem; received honoraria from Janssen and Teva; received research funding from Gilead, Loxo, Sun, and Verastem; and served on data safety monitoring committees for Morphosys and Invectys. P.M.B. received consulting fees for PCYC/AbbVie, Genentech, Gilead, Merck, Seattle Genetics, Verastem, AstraZeneca, Celgene, and Morphosys. C.S.U. received consulting fees from Pharmacyclics, AbbVie, and AstraZeneca. M.B.G. received research support from Amgen. M. Kamdar is a consultant for AZD, Celgene, and Pharmacyclics and received speakers bureau fees from Seattle Genetics. L.H. received research grant support from Gilead and Janssen-Cilag and honoraria from AbbVie; S.M. received research funding from AbbVie, AstraZeneca, BeiGene, Genentech, Gilead, Janssen, Juno, Novartis, Pharmacyclics, and TG Therapeutics and received honorarium for advisory board or lecturing for AbbVie, AstraZeneca, BeiGene, Genentech, Gilead, Janssen, KitePharma, and Pharmacyclics. M.S. received research funding from Mustang Bio, Celgene, Pharmacyclics, Gilead, Genentech, AbbVie, TG Therapeutics, BeiGene, Acerta Pharma, Merck, and has served on advisory boards or as a consultant for AbbVie, Genentech, Astra Zeneca, Sound Biologics, Verastem, ADC Therapeutics, BMS, and Atara Biotherapeutics. E.A.C. is on advisory boards for Novartis, Tessa, BMS, and KitePharma and received research funding from the Lymphoma Research Foundation. D.M.B. is a consultant, scientific advisory board member, and site PI clinical trial (grant paid to institution) for AbbVie, Juno/Celgene/BMS, and Tolero; a scientific advisory board member and site PI clinical trial (grant paid to institution) for ArQule; a site PI clinical trial (grant paid to institution) for Ascentage, BeiGene, DTRM Biopharm, Genentech, MEI Pharma, Pharmacyclics, and Verastem; a consultant and site PI clinical trial (grant paid to institution) for Astra-Zeneca; a consultant and scientific advisory board member for Pfizer; a consultant for Teva; a scientific advisory board member and site PI clinical trial (grant paid to institution) for TG Therapeutics; and has other guidelines/registry memberships (when sponsored or consultant also included under sponsor above) as a National Comprehensive Cancer Network panel member, informCLL registry steering committee (Abb-Vie), REAL registry steering committee (Verastem), and Biosimilars outcomes research panel (Pfizer). R.W. attends meetings and gives educational talks for AbbVie, Janssen, and Gilead. A.B. received travel expenses and speakers fees from Gilead; received travel/conference support from PEMP AbbVie; is a remunerated speaker and consultant for Astra Zeneca; is a remunerated speaker and consultant for Atura; is a consultant for Gilead; received research funding and travel/conference support and is a remunerated speaker and consultant for Janssen; received travel/conference support and is a remunerated speaker and consultant for Novartis, Roche, and Tolero Pharmaceuticals. J.-Á.H.-R. is a consultant for Janssen, AbbVie, Roche, Gilead, Celgene, AstraZeneca, and Rovi; received speakers bureau fees from Janssen, AbbVie, Roche, Gilead, Celgene, and AstraZeneca; and received grant/research support from Celgene and is a major shareholder. R.C. received speakers bureau fees from Roche, Janssen, BMS, AbbVie, and Takeda; received advisory fees from Janssen, Celgene, AbbVie, Servier, Kyowa-Kirin, and Takeda; and received travel and accommodation fees from Roche, Pfizer, Jans-sen, Celgene, AbbVie, Servier, and Takeda. T.A.E. received honoraria from Roche, Gilead, AbbVie, and Janssen; holds an advisory board role for Gilead, AbbVie, and AstraZeneca; has received research funding from Gilead; and has travelled to conferences for Takeda, AbbVie, and Janssen. The remaining authors declare no competing financial interests.
Publisher Copyright:
© 2020 American Society of Hematology. All rights reserved.
PY - 2020/9/3
Y1 - 2020/9/3
N2 - Given advanced age, comorbidities, and immune dysfunction, chronic lymphocytic leukemia (CLL) patients may be at particularly high risk of infection and poor outcomes related to coronavirus disease 2019 (COVID-19). Robust analysis of outcomes for CLL patients, particularly examining effects of baseline characteristics and CLL-directed therapy, is critical to optimally manage CLL patients through this evolving pandemic. CLL patients diagnosed with symptomatic COVID-19 across 43 international centers (n 5 198) were included. Hospital admission occurred in 90%. Median age at COVID-19 diagnosis was 70.5 years. Median Cumulative Illness Rating Scale score was 8 (range, 4-32). Thirty-nine percent were treatment naive (“watch and wait”), while 61% had received ‡1 CLL-directed therapy (median, 2; range, 1-8). Ninety patients (45%) were receiving active CLL therapy at COVID-19 diagnosis, most commonly Bruton tyrosine kinase inhibitors (BTKi’s; n 5 68/90 [76%]). At a median follow-up of 16 days, the overall case fatality rate was 33%, though 25% remain admitted.mortality (37% vs 32%). CLL-directed treatment with BTKi’s at COVID-19 diagnosis did not impact survival (case fatality rate, 34% vs 35%), though the BTKi was held during the COVID-19 course for most patients. These data suggest that the subgroup of CLL patients admitted with COVID-19, regardless of disease phase or treatment status, are at high risk of death. Future epidemiologic studies are needed to assess severe acute respiratory syndrome coronavirus 2 infection risk, these data should be validated independently, and randomized studies of BTKi’s in COVID-19 are needed to provide definitive evidence of benefit.mortality (37% vs 32%). CLL-directed treatment with BTKi’s at COVID-19 diagnosis did not impact survival (case fatality rate, 34% vs 35%), though the BTKi was held during the COVID-19 course for most patients. These data suggest that the subgroup of CLL patients admitted with COVID-19, regardless of disease phase or treatment status, are at high risk of death. Future epidemiologic studies are needed to assess severe acute respiratory syndrome coronavirus 2 infection risk, these data should be validated independently, and randomized studies of BTKi’s in COVID-19 are needed to provide definitive evidence of benefit.
AB - Given advanced age, comorbidities, and immune dysfunction, chronic lymphocytic leukemia (CLL) patients may be at particularly high risk of infection and poor outcomes related to coronavirus disease 2019 (COVID-19). Robust analysis of outcomes for CLL patients, particularly examining effects of baseline characteristics and CLL-directed therapy, is critical to optimally manage CLL patients through this evolving pandemic. CLL patients diagnosed with symptomatic COVID-19 across 43 international centers (n 5 198) were included. Hospital admission occurred in 90%. Median age at COVID-19 diagnosis was 70.5 years. Median Cumulative Illness Rating Scale score was 8 (range, 4-32). Thirty-nine percent were treatment naive (“watch and wait”), while 61% had received ‡1 CLL-directed therapy (median, 2; range, 1-8). Ninety patients (45%) were receiving active CLL therapy at COVID-19 diagnosis, most commonly Bruton tyrosine kinase inhibitors (BTKi’s; n 5 68/90 [76%]). At a median follow-up of 16 days, the overall case fatality rate was 33%, though 25% remain admitted.mortality (37% vs 32%). CLL-directed treatment with BTKi’s at COVID-19 diagnosis did not impact survival (case fatality rate, 34% vs 35%), though the BTKi was held during the COVID-19 course for most patients. These data suggest that the subgroup of CLL patients admitted with COVID-19, regardless of disease phase or treatment status, are at high risk of death. Future epidemiologic studies are needed to assess severe acute respiratory syndrome coronavirus 2 infection risk, these data should be validated independently, and randomized studies of BTKi’s in COVID-19 are needed to provide definitive evidence of benefit.mortality (37% vs 32%). CLL-directed treatment with BTKi’s at COVID-19 diagnosis did not impact survival (case fatality rate, 34% vs 35%), though the BTKi was held during the COVID-19 course for most patients. These data suggest that the subgroup of CLL patients admitted with COVID-19, regardless of disease phase or treatment status, are at high risk of death. Future epidemiologic studies are needed to assess severe acute respiratory syndrome coronavirus 2 infection risk, these data should be validated independently, and randomized studies of BTKi’s in COVID-19 are needed to provide definitive evidence of benefit.
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UR - http://www.scopus.com/inward/citedby.url?scp=85089864394&partnerID=8YFLogxK
U2 - 10.1182/blood.2020006965
DO - 10.1182/blood.2020006965
M3 - Article
C2 - 32688395
AN - SCOPUS:85089864394
SN - 0006-4971
VL - 136
SP - 1134
EP - 1143
JO - Blood
JF - Blood
IS - 10
ER -