Key findings from the UKCCMP cohort of 877 patients with haematological malignancy and COVID-19: disease control as an important factor relative to recent chemotherapy or anti-CD20 therapy.
Stephen BoothHelen M CurleyCsilla VarnaiRoland ArnoldLennard Y W LeeNaomi A CamptonCurly T C M MorrisKarin PurshouseJames AriesAndrew InnesLucy B CookOliver TomkinsHelen S OramMichael TilbyAustin G KulasekararajDavid WrenchSaoirse DollyTom Newsom-DaviesRuth PettengellAbigail GaultSam MoodySajjan MittalMohammed O A AltohamiTania TilletJack IllingworthLeena MukherjeeJane ApperlyJohn AshcroftNeil RabinJonathan CarmichaelJean-Baptiste CazierRachel KerrGary MiddletonGraham P CollinsClaire Pallesnull nullPublished in: British journal of haematology (2021)
Patients with haematological malignancies have a high risk of severe infection and death from SARS-CoV-2. In this prospective observational study, we investigated the impact of cancer type, disease activity, and treatment in 877 unvaccinated UK patients with SARS-CoV-2 infection and active haematological cancer. The primary end-point was all-cause mortality. In a multivariate analysis adjusted for age, sex and comorbidities, the highest mortality was in patients with acute leukaemia [odds ratio (OR) = 1·73, 95% confidence interval (CI) 1·1-2·72, P = 0·017] and myeloma (OR 1·3, 95% CI 0·96-1·76, P = 0·08). Having uncontrolled cancer (newly diagnosed awaiting treatment as well as relapsed or progressive disease) was associated with increased mortality risk (OR = 2·45, 95% CI 1·09-5·5, P = 0·03), as was receiving second or beyond line of treatment (OR = 1·7, 95% CI 1·08-2·67, P = 0·023). We found no association between recent cytotoxic chemotherapy or anti-CD19/anti-CD20 treatment and increased risk of death within the limitations of the cohort size. Therefore, disease control is an important factor predicting mortality in the context of SARS-CoV-2 infection alongside the possible risks of therapies such as cytotoxic treatment or anti-CD19/anti-CD20 treatments.
Keyphrases
- sars cov
- disease activity
- coronavirus disease
- papillary thyroid
- rheumatoid arthritis
- acute myeloid leukemia
- mass spectrometry
- squamous cell carcinoma
- respiratory syndrome coronavirus
- multiple myeloma
- cardiovascular events
- early onset
- mesenchymal stem cells
- replacement therapy
- anti inflammatory
- high resolution
- lymph node metastasis