COVID-19 in persons with chronic myeloid leukaemia
Weiming Li1, Danyu Wang2, Jingming Guo3
1Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. lee937@126.com.
Insights
Chronic myeloid leukaemia (CML) patients had a higher COVID-19 prevalence than the general population. Risk factors included SARS-CoV-2 exposure, lack of hematologic response, and comorbidities.
Area of Science:
- Hematology
- Infectious Diseases
- Epidemiology
Background:
- Chronic myeloid leukaemia (CML) is a myeloproliferative neoplasm.
- The SARS-CoV-2 pandemic impacted vulnerable populations, including cancer patients.
- Understanding COVID-19 risk in CML patients is crucial for management.
Purpose of the Study:
- To determine the prevalence of COVID-19 in CML patients in Hubei Province during the SARS-CoV-2 epidemic.
- To identify risk factors associated with developing COVID-19 in CML patients.
- To compare COVID-19 prevalence in CML patients with normal populations and other cancer patient groups.
Main Methods:
- A questionnaire-based study involving 530 CML patients in Hubei Province.
- Data collection on COVID-19 diagnosis, CML status, treatment, and potential exposures.
- Statistical analysis to identify co-variates associated with increased COVID-19 risk.
Main Results:
- The prevalence of COVID-19 in CML patients was 0.9%, ninefold higher than in the general population.
- Increased risk was associated with SARS-CoV-2 exposure, no complete hematologic response, and comorbidities.
- Advanced phase CML patients showed increased risk, irrespective of cytogenetic or molecular response.
Conclusions:
- CML patients exhibit a higher risk of COVID-19 compared to the general population.
- Specific factors like exposure, hematologic response, and comorbidities significantly increase COVID-19 risk in CML.
- Targeted surveillance and protective measures are recommended for CML patients with identified risk factors.
Abstract:
We studied by questionnaire 530 subjects with chronic myeloid leukaemia (CML) in Hubei Province during the recent SARS-CoV-2 epidemic. Five developed confirmed (N = 4) or probable COVID-19 (N = 1). Prevalence of COVID-19 in our subjects, 0.9% (95% Confidence Interval, 0.1, 1.8%) was ninefold higher than 0.1% (0, 0.12%) reported in normals but lower than 10% (6, 17%) reported in hospitalised persons with other haematological cancers or normal health-care providers, 7% (4, 12%). Co-variates associated with an increased risk of developing COVID-19 amongst persons with CML were exposure to someone infected with SARS-CoV-2 (P = 0.037), no complete haematologic response (P = 0.003) and co-morbidity(ies) (P = 0.024). There was also an increased risk of developing COVID-19 in subjects in advanced phase CML (P = 0.004) even when they achieved a complete cytogenetic response or major molecular response at the time of exposure to SARS-CoV-2. 1 of 21 subjects receiving 3rd generation tyrosine kinase-inhibitor (TKI) developed COVID-19 versus 3 of 346 subjects receiving imatinib versus 0 of 162 subjects receiving 2nd generation TKIs (P = 0.096). Other co-variates such as age and TKI-therapy duration were not significantly associated with an increased risk of developing COVID-19. Persons with these risk factors may benefit from increased surveillance of SARS-CoV-2 infection and possible protective isolation.
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