How risky is COVID-19 for chronic lymphocytic leukemia patients?
According to an international multi-center descriptive study, a higher rate of death was found in chronic lymphocytic leukemia (CLL) with Covid-19, whether patients were receiving therapy at the time of infection, had received CLL treatment previously, or were being watched.
The mortality rate for patients on active CLL-directed therapy at the time of Covid-19 diagnosis was 28%, according to Anthony Mato, MD, Memorial Sloan Kettering Cancer Center, New York City. Similar fatality rates of 32% for patients who had received CLL-directed therapy previously and 37 for watch-and-wait patients.
The hypothesis behind the higher mortality rate is attributed to the impaired humoral and cellular immune function that increases the risk of infections and hence mortalities.
CLL patients with COVID-19 suffered from the following symptoms:
- Fever 88%
- Cough 85%
- Fatigue and dyspnea 70%
- Myalgia or arthralgia 36%
Interestingly, a similar rate in hospital admission, ICU admission, and between patients who had previously received treatment for CLL and the watch-and-wait group.
Moreover, 92% of patients that were admitted needed supplemental oxygen, 38% required admission to the intensive care unit (ICU), 27% needed IV vasopressor support, and 11% required dialysis.
In conclusion, CLL patients are at a higher risk due to impaired humoral and cellular immune function. The treatment stage didn’t impact the mortality rate of CLL patients whether they are on active treatment, received treatment, or are on watch and wait for strategy. Patients and their families should take all precautions to reduce the risk of infection with COVID-19.
Reference: Mato AR, et al “Outcomes of Covid-19 in patients with CLL: A multicenter international experience”Blood 2020;136(10): 1134-1143.
