Author:
Marchesi Francesco,Salmanton-García Jon,Emarah Ziad,Piukovics Klára,Nucci Marcio,López-García Alberto,Ráčil Zdeněk,Farina Francesca,Popova Marina,Zompi Sofia,Audisio Ernesta,Ledoux Marie-Pierre,Verga Luisa,Weinbergerová Barbora,Szotkovski Tomas,Da Silva Maria Gomes,Fracchiolla Nicola,De Jonge Nick,Collins Graham,Marchetti Monia,Magliano Gabriele,García-Vidal Carolina,Biernat Monika M.,Van Doesum Jaap,Machado Marina,Demirkan Fatih,Al-Khabori Murtadha,Žák Pavel,Víšek Benjamín,Stoma Igor,Méndez Gustavo-Adolfo,Maertens Johan,Khanna Nina,Espigado Ildefonso,Dragonetti Giulia,Fianchi Luana,Del Principe Maria Ilaria,Cabirta Alba,Ormazabal-Vélez Irati,Jaksic Ozren,Buquicchio Caterina,Bonuomo Valentina,Batinić Josip,Omrani Ali S.,Lamure Sylvain,Finizio Olimpia,Fernández Noemí,Falces-Romero Iker,Blennow Ola,Bergantim Rui,Ali Natasha,Win Sein,Van Praet Jens,Tisi Maria Chiara,Shirinova Ayten,Schönlein Martin,Prattes Juergen,Piedimonte Monica,Petzer Verena,Navrátil Milan,Kulasekararaj Austin,Jindra Pavel,Sramek Jiří,Glenthøj Andreas,Fazzi Rita,De Ramón-Sánchez Cristina,Cattaneo Chiara,Calbacho Maria,Bahr Nathan C.,El-Ashwah Shaimaa,Cordoba Raul,Hanakova Michaela,Zambrotta Giovanni,Sciumè Mariarita,Booth Stephen,Rodrigues Raquel Nunes,Sacchi Maria Vittoria,García-Poutón Nicole,Martín-González Juan-Alberto,Khostelidi Sofya,Gräfe Stefanie,Rahimli Laman,Ammatuna Emanuele,Busca Alessandro,Corradini Paolo,Hoenigl Martin,Klimko Nikolai,Koehler Philipp,Pagliuca Antonio,Passamonti Francesco,Cornely Oliver A.,Pagano Livio
Abstract
Patients with acute myeloid leukemia (AML) are at high risk of dying from coronavirus disease 2019 (COVID-19). The optimal management of AML patients with COVID-19 has not been established. Our multicenter study included 388 adult AML patients diagnosed with COVID-19 between February 2020 and October 2021. The vast majority were receiving or had received AML treatment in the preceding 3 months. COVID-19 was severe in 41.2% and critical in 21.1% of cases. The chemotherapeutic schedule was modified in 174 patients (44.8%), delayed in 68 and permanently discontinued in 106. After a median follow-up of 325 days, 180 patients (46.4%) had died; death was attributed to COVID-19 (43.3%), AML (26.1%) or to a combination of both (26.7%), whereas in 3.9% of cases the reason was unknown. Active disease, older age, and treatment discontinuation were associated with death, whereas AML treatment delay was protective. Seventy-nine patients had a simultaneous AML and COVID-19 diagnosis, with better survival when AML treatment could be delayed (80%; P<0.001). Overall survival in patients with a diagnosis of COVID-19 between January 2020 and August 2020 was significantly lower than that in patients diagnosed between September 2020 and February 2021 and between March 2021 and September 2021 (39.8% vs. 60% vs. 61.9%, respectively; P=0.006). COVID-19 in AML patients was associated with a high mortality rate and modifications of therapeutic algorithms. The best approach to improve survival was to delay AML treatment, whenever possible.
Publisher
Ferrata Storti Foundation (Haematologica)