Outcomes of COVID-19 in patients with CLL: a multicenter international experience

Area of Science:

• Hematology
• Infectious Diseases
• Oncology

Background:

• Chronic lymphocytic leukemia (CLL) patients are immunocompromised, increasing vulnerability to severe infections like coronavirus disease 2019 (COVID-19).
• Understanding COVID-19 outcomes in CLL patients, considering their baseline characteristics and ongoing therapies, is crucial for pandemic management.

Purpose of the Study:

• To analyze the outcomes of chronic lymphocytic leukemia patients diagnosed with symptomatic COVID-19.
• To examine the impact of baseline characteristics and chronic lymphocytic leukemia-directed therapies on COVID-19 outcomes in this patient population.

Main Methods:

• A cohort of 198 chronic lymphocytic leukemia patients with symptomatic COVID-19 from 43 international centers was analyzed.
• Data collected included patient demographics, Cumulative Illness Rating Scale scores, treatment status (treatment-naive vs. treated), and active therapies at COVID-19 diagnosis, including Bruton tyrosine kinase inhibitors (BTKi's).

Main Results:

• Ninety percent of patients required hospital admission, with a median age of 70.5 years and significant comorbidity burden.
• The overall case fatality rate was 33%. Treatment-naive and treated cohorts showed similar rates of admission, ICU admission, intubation, and mortality.
• Active Bruton tyrosine kinase inhibitor therapy at COVID-19 diagnosis did not impact survival, although BTKi was often held during the COVID-19 illness.

Conclusions:

• Chronic lymphocytic leukemia patients hospitalized with COVID-19 are at a high risk of death, irrespective of their disease phase or treatment status.
• Further epidemiologic studies are needed to assess severe acute respiratory syndrome coronavirus 2 infection risk in CLL patients.
• Independent validation of these findings and randomized trials of Bruton tyrosine kinase inhibitors in COVID-19 are warranted.