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COVID-19 in patients with chronic lymphocytic leukemia: a Moscow observational study

Оlga L Kochneva1, Maria Kislova2, Evgenya I Zhelnova1

  • 1City Clinical Hospital No. 52, Moscow, Russia.

Leukemia & Lymphoma
|February 14, 2022
PubMed

Insights

Patients with chronic lymphocytic leukemia (CLL) face severe COVID-19 due to immunodeficiency. Treatments showed limited impact, highlighting the need for early antivirals and tailored vaccination for better outcomes.

Area of Science:

  • Hematology
  • Infectious Diseases
  • Oncology

Background:

  • Chronic lymphocytic leukemia (CLL) is an immunodeficiency disorder.
  • COVID-19 poses a significant risk to immunocompromised patients.
  • Understanding COVID-19 severity and treatment in CLL patients is crucial.

Purpose of the Study:

  • To analyze factors associated with severe COVID-19 in CLL patients.
  • To evaluate the impact of different treatment regimens on COVID-19 outcomes in CLL.
  • To identify biomarkers for disease severity in CLL patients with COVID-19.

Main Methods:

  • Retrospective cohort study of 156 CLL patients diagnosed with COVID-19.
  • Analysis of anti-SARS-CoV-2 antibody levels (IgG, IgM).
  • Assessment of interleukin-6 (IL-6) as a biomarker.
  • Comparison of overall survival (OS) based on treatment regimens (ibrutinib, anti-CD20, chemotherapy, glucocorticoids, anti-cytokine compounds).

Main Results:

  • CLL patients exhibited lower anti-SARS-CoV-2 IgG and IgM levels.
  • Higher IL-6 levels correlated with severe COVID-19.
  • A 20% fatality rate was observed, with 10% experiencing recurrent episodes.
  • No significant OS difference between ibrutinib monotherapy and anti-CD20 antibodies ± chemotherapy.
  • Immunodeficiency inherent to CLL appeared to be a greater determinant of outcomes than treatment.

Conclusions:

  • CLL patients are prone to severe COVID-19, with IL-6 as a severity biomarker.
  • Current treatments have limited impact on survival, suggesting immunodeficiency is the primary driver.
  • Reorganization of healthcare, early antiviral administration, and tailored vaccination protocols are necessary for managing COVID-19 in CLL patients.

Keywords:
COVID-19Chronic lymphocytic leukemiaanti-cytokine therapyglucocorticoid therapyspecific antibody response

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