COVID-19 in adult acute myeloid leukemia patients: a long-term follow-up study from the European Hematology Association survey (EPICOVIDEHA)

Francesco Marchesi, Jon Salmanton-García*, Ziad Emarah, Klára Piukovics, Marcio Nucci, Alberto López-García, Zdeněk Ráčil, Francesca Farina, Marina Popova, Sofia Zompi, Ernesta Audisio, Marie Pierre Ledoux, Luisa Verga, Barbora Weinbergerová, Tomas Szotkovski, Maria Gomes Da Silva, Nicola Fracchiolla, Nick De Jonge, Graham Collins, Monia MarchettiGabriele Magliano, Carolina García-Vidal, Monika M. Biernat, Jaap Van Doesum, Marina Machado, Fatih Demirkan, Murtadha Al-Khabori, Pavel Žák, Benjamín Víšek, Igor Stoma, Gustavo Adolfo Méndez, Johan Maertens, Nina Khanna, Ildefonso Espigado, Giulia Dragonetti, Luana Fianchi, Maria Ilaria Del Principe, Alba Cabirta, Irati Ormazabal-Vélez, Ozren Jaksic, Caterina Buquicchio, Valentina Bonuomo, Josip Batinić, Ali S. Omrani, Sylvain Lamure, Olimpia Finizio, Noemí Fernández, Iker Falces-Romero, Ola Blennow, Rui Bergantim, Natasha Ali, Sein Win, Jens Van Praet, Maria Chiara Tisi, Ayten Shirinova, Martin Schönlein, Juergen Prattes, Monica Piedimonte, Verena Petzer, Milan Navrátil, Austin Kulasekararaj, Pavel Jindra, Jiří Sramek, Andreas Glenthøj, Rita Fazzi, Cristina De Ramón-Sánchez, Chiara Cattaneo, Maria Calbacho, Nathan C. Bahr, Shaimaa El-Ashwah, Raul Cordoba, Michaela Hanakova, Giovanni Zambrotta, Giovanni Zambrotta, Mariarita Sciumè, Stephen Booth, Raquel Nunes Rodrigues, Maria Vittoria Sacchi, Nicole García-Poutón, Juan Alberto Martín-González, Sofya Khostelidi, Stefanie Gräfe, Laman Rahimli, Emanuele Ammatuna, Alessandro Busca, Paolo Corradini, Martin Hoenigl, Nikolai Klimko, Philipp Koehler, Antonio Pagliuca, Francesco Passamonti, Oliver A. Cornely, Livio Pagano

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

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    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.

    Original languageEnglish
    Pages (from-to)22-33
    Number of pages12
    JournalHaematologica
    Volume108
    Issue number1
    DOIs
    Publication statusPublished - Jan-2023

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