Outcome of SARS-CoV-2-Infected Polish Patients with Chronic Lymphocytic Leukemia

SIMPLE SUMMARY: The severe acute respiratory syndrome coronavirus (SARS-CoV-2) has become the cause of a worldwide pandemic, and its clinical infection course in patients with hematological malignancies may be severe. Chronic lymphocytic leukemia (CLL) patients are among this group, and CLL-directed therapies are discussed as potential COVID-19-severity modifying agents. So far, the published data and clinical experience in treatment of COVID-19 patients with CLL are still scarce. Therefore, we aimed at retrospectively analyzing factors associated with SARS-CoV-2 infection course in patients with CLL. ABSTRACT: Background. The severe acute respiratory syndrome coronavirus (SARS-CoV-2) has become the cause of a worldwide pandemic, and its clinical infection course in patients with hematological malignancies may be severe. Methods. We performed a retrospective study on 188 chronic lymphocytic leukemia patients (CLL) with COVID-19 infection. Results. At the time of infection 51 patients (27.1%) were treated with Bruton tyrosine kinase inhibitor (BTKi), 46 (24.5%) with anti-CD20 antibodies while 37 patients (19.7%) received venetoclax. In total, 111 patients (59.0%) required hospitalization and 50 patients (26.5%) died due to COVID-19. Patients with poor performance status (ECOG >1; p = 0.02), advanced age (>65 years; p = 0.04), low hemoglobin concentration (≤10 g/dl; p = 0.0001), low platelets (<100 × 109/L; p = 0.003), and elevated lactate dehydrogenase level (LDH; p = 0.014) had an increased risk of death due to COVID-19. Neither CLL treatment status (treatment naïve vs. treated) nor the type of CLL-directed treatment had impact on the SARS-CoV-2 related risk of death. The multivariate survival analysis showed that advanced age (p = 0.009) and low platelet count (p = 0.0001) were associated with significantly shorter patients’ overall survival. Conclusions. SARS-CoV-2 infection in CLL patients is associated with poor outcome regardless of administered CLL-directed treatment.