COVID-19 among fit patients with CLL treated with venetoclax-based combinations

With more than 5 million proven infections and more than 300,000 associated deaths worldwide [1], the SARS-CoV-2 pandemic poses unprecedented challenges to health-care professionals and especially those treating and caring for patients with malignant hematological diseases. These patients often have...

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Autores:
Tipo de recurso:
Article of journal
Fecha de publicación:
2020
Institución:
Universidad de Bogotá Jorge Tadeo Lozano
Repositorio:
Expeditio: repositorio UTadeo
Idioma:
eng
OAI Identifier:
oai:expeditiorepositorio.utadeo.edu.co:20.500.12010/12895
Acceso en línea:
https://www.nature.com/articles/s41375-020-0941-7
http://hdl.handle.net/20.500.12010/12895
https://doi.org/10.1038/s41375-020-0941-7
Palabra clave:
venetoclax
leukemia
Síndrome respiratorio agudo grave
COVID-19
SARS-CoV-2
Coronavirus
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License
Acceso restringido
Description
Summary:With more than 5 million proven infections and more than 300,000 associated deaths worldwide [1], the SARS-CoV-2 pandemic poses unprecedented challenges to health-care professionals and especially those treating and caring for patients with malignant hematological diseases. These patients often have multiple different risk factors for severe infections [2]. Chronic lymphocytic leukemia (CLL) is the most common form of leukemia and infections are a known contributor to morbidity and mortality due to a disease-inherent immunodeficiency [3, 4]. Considering this multifactorial immune defect, it appears conceivable that patients with CLL are more susceptible to infections with SARS-CoV-2 and more likely to develop severe courses of the associated respiratory disease COVID-19, especially when under additional immunosuppression by chemoimmunotherapy (CIT). Few case reports on COVID-19 in CLL patients from countries with suspected different prevalence rates of COVID-19 have been published so far. The publications report a patient after first-line treatment with single-agent chlorambucil, a case series with four treatment-naive CLL patients, a case series of eight patients on Bruton tyrosine kinase (BTK) inhibitors and most recently a heterogeneously treated population of four patients from the Hospital Clinic of Barcelona [5,6,7,8]. While it has been hypothesized that the BTK inhibitor ibrutinib might have protective effects against COVID-19 by attenuating hyperinflammatory responses, there is currently no data on COVID-19 in patients receiving venetoclax-based treatments [7, 9]. A recent study has suggested a reduction of CLL-inherent immunosuppression after successful treatment with venetoclax-based regimens [10]. In light of these data we sought to determine the incidence, severity, and possible risk factors of COVID-19 cases in a well-defined cohort of patients with CLL receiving venetoclax-based combination treatments as first-line therapy in a prospective clinical trial.