COVID-19 INFECTION IN CHRONIC MYELOID LEUKEMIA AFTER 1 YEAR OF THE PANDEMIC IN ITALY. A CAMPUS CML ANALYSIS
Author(s): ,
Massimo Breccia
Affiliations:
Department of Translational and Precision Medicine,Sapienza University,Roma,Italy
,
Elisabetta Abruzzese
Affiliations:
Hematology,S.Eugenio Hospital,Rome,Italy
,
Vincenzo Accurso
Affiliations:
UO di ematologia con trapianto,AU Policlinico Paolo Giaccone,Palermo,Italy
,
Immacolata Attolico
Affiliations:
UO Ematologia con trapianto,Università degli studi di Bari Aldo Moro,Bari,Italy
,
Sara Barulli
Affiliations:
Div. di Ematologia di Muraglia,CTMO Ospedale San Salvatore,Pesaro,Italy
,
Micaela Bergamaschi
Affiliations:
Ematologia,Ospedale Santa Corona,Pietra Ligure,Italy
,
Gianni Binotto
Affiliations:
Ematologia ed Immunologia Clinica,Università degli Studi di Padova,Padova,Italy
,
Monica Bocchia
Affiliations:
U.O.C. Ematologia e Trapianti,A.O. Senese - Policlinico ' Le Scotte',Siena,Italy
,
Massimiliano Bonifacio
Affiliations:
Istituti Ospitalieri di Verona- Div. di Ematologia,Policlinico G.B. Rossi,Verona,Italy
,
Giovanni Caocci
Affiliations:
CTMO - Ematologia,Ospedale 'Businco',Cagliari,Italy
,
Isabella Capodanno
Affiliations:
Ematologia,Azienda Unità Sanitaria Locale-IRCCS,Reggio Emilia,Italy
,
Fausto Castagnetti
Affiliations:
Istituto di Ematologia 'Lorenzo e A. Seragnoli',Policlinico S. Orsola – Malpighi,Bologna,Italy
,
Francesco Cavazzini
Affiliations:
Ematologia,Arcispedale Sant'Anna,Ferrara,Italy
,
Elena Crisà
Affiliations:
S.C.D.U. Ematologia - DIMECS e Dipartimento Oncologico,Università del Piemonte Orientale Amedeo Avogadro,Novara,Italy
,
Monica Crugnola
Affiliations:
Ematologia,Università degli Studi di Parma,Parma,Italy
,
Maria Stella De Candia
Affiliations:
UOC Ematologia con Trapianto,Brindisi Hospital,Brindisi,Italy
,
Chiara Elena
Affiliations:
Ematologia,Fondazione IRCCS Policlinico S. Matteo,Pavia,Italy
,
Carmen Fava
Affiliations:
Struttura Complessa a Dir. Universitaria-Ematologia e Terapie Cellulari,A.S.O. Ordine Mauriziano, P.O. Umberto I,Torino,Italy
,
Sara Galimberti
Affiliations:
Ematologia,Università di Pisa - Azienda Ospedaliera Pisana,Pisa,Italy
,
Antonella Gozzini
Affiliations:
Unità di Ricerca e di Malattie del sangue,Ematologia San Luca Vecchio Pad. 16 - 1° Piano,Firenze,Italy
,
Gabriele Gugliotta
Affiliations:
Istituto di Ematologia 'Lorenzo e A. Seragnoli',Policlinico S. Orsola – Malpighi,Bologna,Italy
,
Tamara Intermesoli
Affiliations:
Hematology,Bergamo Hopsital,Bergamo,Italy
,
Alessandra Iurlo
Affiliations:
UOC Ematologia,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico,Milano,Italy
,
Gaetano La Barba
Affiliations:
U.O. Ematologia Clinica,Azienda USL di Pescara,Pescara,Italy
,
Roberto Latagliata
Affiliations:
Ematologia,Ospedale Belcolle,Viterbo,Italy
,
Sabrina Leonetti Crescenzi
Affiliations:
Ematologia,Ospedale S. Giovanni Addolorata,Roma,Italy
,
Luciano Levato
Affiliations:
Ematologia,Ospedale Catanzaro,Catanzaro,Italy
,
Giuseppina Loglisci
Affiliations:
Ematologia,Ospedale Lecce,Lecce,Italy
,
Alessandro Lucchesi
Affiliations:
Ematologia,Istituto Tumori della Romagna IRST IRCCS,Meldola,Italy
,
Luigiana Luciano
Affiliations:
Ematologia,Azienda Ospedaliera Universitaria - Università degli Studi di Napoli 'Federico II',Napoli,Italy
,
Francesca Lunghi
Affiliations:
Ematologia,Ospedale S. Raffaele,Milano,Italy
,
Debora Luzi
Affiliations:
Ematologia,A.O. Santa Maria - Terni S.C Oncoematologia,Terni,Italy
,
Alessandra Malato
Affiliations:
Ematologia,Ospedali Riuniti 'Villa Sofia-Cervello',Palermo,Italy
,
Maria Cristina Miggiano
Affiliations:
Ematologia,Ospedale Vicenza,Vicenza,Italy
,
Michele Pizzuti
Affiliations:
Ematologia,Ospedale Potenza,Potenza,Italy
,
Patrizia Pregno
Affiliations:
Dipartimento di Oncologia ed Ematologia S.C. Ematologia 2,A.O. Città della Salute e della Scienza di Torino S. G.Battista,Torino,Italy
,
Davide Rapezzi
Affiliations:
Ematologia,Ospedale Cuneo,Cuneo,Italy
,
Giovanna Rege-Cambrin
Affiliations:
Dip. di Scienze Cliniche e Biologiche,Ospedale S. Luigi Gonzaga-Medicina Interna 2,Orbassano,Italy
,
Gianantonio Rosti
Affiliations:
Ematologia,Istituto Tumori della Romagna IRST IRCCS,Meldola,Italy
,
Sabina Russo
Affiliations:
Dipartimento di Medicina Interna,Azienda Ospedaliera Universitaria - Policlinico G. Martino,Messina,Italy
,
Rosaria Sancetta
Affiliations:
Ematologia,Ospedale Mestre,Mestre,Italy
,
Anna Rita Scortechini
Affiliations:
Ematologia,Azienda Ospedaliero Universitaria Ospedali Riuniti,Ancona,Italy
,
Federica Sorà
Affiliations:
Ematologia,Policlinico Gemelli – Università cattolica del Sacro Cuore,Roma,Italy
,
Paolo Sportoletti
Affiliations:
Ematologia,Ospedale Perugia,Perugia,Italy
,
Fabio Stagno
Affiliations:
Università di Catania - Cattedra di Ematologia,Ospedale 'Ferrarotto',Catania,Italy
,
Agostino Tafuri
Affiliations:
Ematologia,AOU S. Andrea,Roma,Italy
,
Mario Tiribelli
Affiliations:
Clinica Ematologica-Centro Trapianti e Terapie cellulari,Azienda Ospedaliero-Universitaria,Udine,Italy
,
Robin Foà
Affiliations:
Department of Translational and Precision Medicine,Sapienza University,Roma,Italy
Giuseppe Saglio
Affiliations:
Struttura Complessa a Dir. Universitaria-Ematologia e Terapie Cellulari-,A.S.O. Ordine Mauriziano, P.O. Umberto I,Torino,Italy
EHA Library. Breccia M. 06/09/21; 324562; S154
Dr. Massimo Breccia
Dr. Massimo Breccia
Contributions
Abstract
Presentation during EHA2021: All Oral presentations will be made available as of Friday, June 11, 2021 (09:00 CEST) and will be accessible for on-demand viewing until August 15, 2021 on the Virtual Congress platform.

Abstract: S154

Type: Oral Presentation

Session title: Response, resistance and treatment-free remission in CML

Background

An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) started in December 2019 in the province of Hubei in China. Italy was one of the most affected countries with many cases diagnosed already in February 2020 and a lockdown was declared on March 9th. Limited information has been reported with regard to the impact of the pandemic on chronic myeloid leukemia (CML) patients.

Aims

To observe the temporal course of Covid-19 infection and the characteristics of positive patients

Methods
The Campus CML Italian group carried out a first survey on the management of CML patients during the lockdown. We launched a second survey during the pandemic phases 2 and 3, between May 2020 and January 2021. 

Results

We collected retrospective information on 8665 CML patients followed at 46 centers throughout the country. Within this cohort, we recorded 217 Covid-19-positive symptomatic patients (2.5%). Most patients (57%) were diagnosed as having Covid-19 infection between September 2020 and January 2021; 30% were diagnosed in phase 1 (March-April 2020) and only 13% between May and August. Most of the positive patients were between 50 and 65 years (35%), while 26% had less than 50 years, 18.8% were between 65 and 75 years, and 11% had more than 75 years. A male prevalence was observed (73%). The median time from CML diagnosis to Covid-19 infection was 6 years (3 months-18 years). Fifty-six percent of patients presented concomitant comorbidities at the time of infection. When Covid-19 was diagnosed, 27% of patients were receiving imatinib, 26% nilotinib, 18% dasatinib, 8% ponatinib, 8% bosutinib, 2% asciminib, while 11% were not receive treatment. At the time of the infection, 74% of patients were in molecular remission, 6% in complete cytogenetic remission, 3% in partial cytogenetic remission, 6% in complete hematological response and 11% in treatment-free remission. At diagnosis, 28% of patients presented fever and respiratory symptoms, 13% cough, 10% isolated fever, 13% ageusia, 12% anosmia, 4% had more than 1 symptom, while 20% were completely asymptomatic. Twenty-one patients (9.6%) required hospitalization without the need of respiratory assistance, 18 (8.2%) were hospitalized for respiratory assistance, 8 (3.6%) were admitted to an ICU, while 150 patients (69%) were only quarantined. Twenty-three percent of patients discontinued TKI therapy during the infection. The source of contagion was familiar in 49% of patients, 18% due to work, 3% in healthcare professionals, whereas in 30% was not known. Twelve patients died due to Covid-19 infection with a mortality rate of 5.5% in the positive cohort and of 0.13% in the whole cohort. Five patients reported consequences post-infection: 1 patient reported a Guillan-Barrè syndrome, 1 patient a maculopapular rash, 1 patient a pulmonary fibrosis, 1 patient a bacterial endocarditis and 1 patient was diagnosed as having alterations of the microcirculation.

Conclusion

This study reports the 1-year of data on the Covid-19 infection in a specific hematological malignancy in the European country first hit by the pandemic. A longer follow-up is needed to further define the impact of Covid-19 infection sequelae in CML patients.

Keyword(s): Chronic myeloid leukemia, COVID-19, Tyrosine kinase inhibitor

Presentation during EHA2021: All Oral presentations will be made available as of Friday, June 11, 2021 (09:00 CEST) and will be accessible for on-demand viewing until August 15, 2021 on the Virtual Congress platform.

Abstract: S154

Type: Oral Presentation

Session title: Response, resistance and treatment-free remission in CML

Background

An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) started in December 2019 in the province of Hubei in China. Italy was one of the most affected countries with many cases diagnosed already in February 2020 and a lockdown was declared on March 9th. Limited information has been reported with regard to the impact of the pandemic on chronic myeloid leukemia (CML) patients.

Aims

To observe the temporal course of Covid-19 infection and the characteristics of positive patients

Methods
The Campus CML Italian group carried out a first survey on the management of CML patients during the lockdown. We launched a second survey during the pandemic phases 2 and 3, between May 2020 and January 2021. 

Results

We collected retrospective information on 8665 CML patients followed at 46 centers throughout the country. Within this cohort, we recorded 217 Covid-19-positive symptomatic patients (2.5%). Most patients (57%) were diagnosed as having Covid-19 infection between September 2020 and January 2021; 30% were diagnosed in phase 1 (March-April 2020) and only 13% between May and August. Most of the positive patients were between 50 and 65 years (35%), while 26% had less than 50 years, 18.8% were between 65 and 75 years, and 11% had more than 75 years. A male prevalence was observed (73%). The median time from CML diagnosis to Covid-19 infection was 6 years (3 months-18 years). Fifty-six percent of patients presented concomitant comorbidities at the time of infection. When Covid-19 was diagnosed, 27% of patients were receiving imatinib, 26% nilotinib, 18% dasatinib, 8% ponatinib, 8% bosutinib, 2% asciminib, while 11% were not receive treatment. At the time of the infection, 74% of patients were in molecular remission, 6% in complete cytogenetic remission, 3% in partial cytogenetic remission, 6% in complete hematological response and 11% in treatment-free remission. At diagnosis, 28% of patients presented fever and respiratory symptoms, 13% cough, 10% isolated fever, 13% ageusia, 12% anosmia, 4% had more than 1 symptom, while 20% were completely asymptomatic. Twenty-one patients (9.6%) required hospitalization without the need of respiratory assistance, 18 (8.2%) were hospitalized for respiratory assistance, 8 (3.6%) were admitted to an ICU, while 150 patients (69%) were only quarantined. Twenty-three percent of patients discontinued TKI therapy during the infection. The source of contagion was familiar in 49% of patients, 18% due to work, 3% in healthcare professionals, whereas in 30% was not known. Twelve patients died due to Covid-19 infection with a mortality rate of 5.5% in the positive cohort and of 0.13% in the whole cohort. Five patients reported consequences post-infection: 1 patient reported a Guillan-Barrè syndrome, 1 patient a maculopapular rash, 1 patient a pulmonary fibrosis, 1 patient a bacterial endocarditis and 1 patient was diagnosed as having alterations of the microcirculation.

Conclusion

This study reports the 1-year of data on the Covid-19 infection in a specific hematological malignancy in the European country first hit by the pandemic. A longer follow-up is needed to further define the impact of Covid-19 infection sequelae in CML patients.

Keyword(s): Chronic myeloid leukemia, COVID-19, Tyrosine kinase inhibitor

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