|The following article features coverage from the 2021 American Society of Hematology Annual Meeting. Click here to read more of Cancer Therapy Advisor’s conference coverage.|
An analysis of the American Society of Hematology Research Collaborative (ASH RC) COVID-19 Registry of patients with acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), or acute lymphoblastic leukemia (ALL) found that active disease was associated with an increased risk of developing severe COVID-19. These findings were presented at 2021 ASH Annual Meeting.
The ASH RC COVID-19 Registry “captures data on individuals with a COVID-19 diagnosis who have been or are currently being treated for hematologic malignancy, nonmalignant blood disease, or have a hematologic complication of COVID-19,” said Pinkal Desai, MD, of Weill Cornell Medical College in New York, New York, and lead author of the study.
The aim of this analysis was to evaluate the predictors of outcomes from COVID-19 among patients with AML, ALL, or MDS.
The analysis included 257 patients with AML, MDS, or ALL — 44% of whom had active disease. Severe COVID-19 was defined as intensive care unit (ICU) admission, moderate severity was defined as requiring hospitalization, and mild was defined as no hospital admission. The primary outcome was mortality from COVID-19, and the secondary outcome was COVID-19 severity.
Severe COVID-19 occurred significantly more frequently among patients with active disease (67%) compared with patients in remission (33%; P <.001). Moderate disease was also more common among patients with active disease (55%) compared with those in remission (45%).
Other factors that were significantly associated with developing severe COVID-19 included AML (P =.007), neutropenia (P <.001), and lymphopenia (P =.009) at the time of COVID-19 diagnosis in a univariate analysis.
Overall, 21% of patients died from COVID-19. Mortality was significantly associated with neutropenia at diagnosis (odds ratio [OR], 3.19; 95% CI, 1.31-8.11; P =.01), and estimated prognosis of less than 6 months prior to COVID-19 diagnosis (OR, 8.13; 95% CI, 2.94-24.50; P <.001).
In addition, it was not surprising that forgoing ICU care was also significantly associated with COVID-19 mortality (OR, 6.37; 95% CI, 2.50-16.90; P <.001), Dr Desai said. Patients with active AML with a pre-COVID-19 prognosis of less than 6 months were most likely to refuse ICU care.
Dr Desai concluded that these data suggest that, “if desired by patients, aggressive support for hospitalized patients with COVID-19 is appropriate, regardless of remission status.”
Disclosures: Some of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Read more of Cancer Therapy Advisor’s coverage of the ASH 2021 meeting by visiting the conference page.
Desai P, Goldberg AD, Anderson KC, et al. Clinical predictors of outcome in adult patients with acute leukemias and myelodysplastic syndrome and COVID-19 infection: report from the American Society of Hematology Research Collaborative (ASH RC) Data Hub. Presented at ASH 2021; December 11-14, 2021. Abstract 280.