Low platelet or hemoglobin values may be linked to worse outcomes of COVID-19 for patients with hematologic malignancies, according to results of a retrospective analysis published in Memo – Magazine of European Medical Oncology.
The investigators noted that patients with hematologic malignancies have generally experienced improved survival outcomes due to advances in treatments and medical care. However, immunosuppression linked to these conditions and their treatments can potentially impact outcomes for those with COVID-19. The study objective was to evaluate the impact of SARS-CoV-2 infection on the clinical course and outcomes related to hematologic malignancy, in addition to factors associated with outcomes.
Patients included in this analysis had a history of COVID-19 and had been seen at the Diskapi Yildirim Beyazit Training and Research Hospital in Ankara, Turkey, presenting to the hematology clinic between April 1 and December 31, 2020.
Patients had any of 9 types of hematologic malignancies: acute lymphoid leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL), chronic myeloid leukemia (CML), Hodgkin lymphoma (HL), multiple myeloma (MM), myelodysplastic syndrome (MDS), non-Hodgkin lymphoma (NHL), and Philadelphia chromosome (Ph) negative myeloproliferative neoplasms (MPN).
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A total of 77 patients were evaluated, with a median age of 60 years (range, 27 to 93). The hematologic malignancies most often seen in patients who had COVID-19 in this study were MPN (22.1%), NHL (19.5%), and MM (15.6%). More than half (55.8%) of the patients in this study were undergoing active treatment with chemotherapy, immunotherapy, or immunosuppression.
COVID-19 was symptomatic in 72.7% of the patients. Among those who were symptomatic, fever was reported in 81%, cough in 74%, and weakness in 69%. Approximately half (50.6%; 39 patients) of all patients were hospitalized, and patients hospitalized with COVID-19 had a median length of stay of 8 days (range, 2 to 30). Of the 39 patients who were hospitalized, 16 were placed in intensive care and were intubated.
A total of 16 patients died from COVID-19 in this study, giving a mortality rate of 20.8%. The median time to mortality following COVID-19 diagnosis was 8 days (range, 3 to 53). The hematologic malignancies present in the patients who died from COVID-19 were CLL (4 patients); MPN (3); NHL (3); and AML, MM, and MDS (2 patients each).
Factors that showed statistically significant relationships with hospitalization included older age, presence of diabetes mellitus or chronic obstructive pulmonary disease.
Lower platelet levels and lower hemoglobin levels showed a significant relationship with hospitalization. These factors also were the only ones identified that had a significant relationship with mortality in this population.
“Interestingly, disease subtype, disease state, comorbidity, and age were not found to have an effect on mortality in this study,” the investigators reported. They concluded that low platelet and hemoglobin levels contributed to mortality in this study, and that it is important to take precautions and vaccinate patients in this population against the virus that causes COVID-19.
Reference
Tığlıoğlu P, Albayrak M, Tığlıoğlu M, et al. The outcome of COVID-19 in patients with hematological malignancy. Memo. Published online December 9, 2021. doi:10.1007/s12254-021-00775-5
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