Blood cancers

Patients with blood cancer have a more severe COVID-19 disease course

Tuesday, 25 Aug 2020

Patients with blood cancers have a more severe COVID-19 trajectory compared to patients with solid organ tumours, data from the UK Coronavirus Cancer Monitoring Project (UKCCMP) confirms.

According to the team of researchers, the findings can be used  to assist physicians in informed risk–benefit discussions with their patients, as well as inform an evidenced-based approach to national social isolation policies.

The study published in Lancet Oncology compared adult patients with cancer enrolled in the UKCCMP cohort between March 18 and May 8, 2020, with a parallel non-COVID-19 UK cancer control population.

They found that patients with leukaemia, lymphoma, and myeloma had a more severe COVID-19 trajectory compared with patients with solid organ tumours (odds ratio [OR] 1·57, 95% CI 1·15–2·15; p<0·0043).

Compared with the rest of the UKCCMP cohort, patients with leukaemia showed a significantly increased case–fatality rate (2·25, 1·13–4·57; p=0·023).

After correction for age and sex, patients with haematological malignancies who had recent chemotherapy had an increased risk of death during COVID-19-associated hospital admission (OR 2·09, 95% CI 1·09–4·08; p=0·028).

The study authors suggest that the immunological disruption seen in patients with leukaemia, and the use of intensely myelosuppressive treatment regimens might “result in a combination of risks, in terms of the likelihood of initial SARS-CoV-2 infection, its ability to gain a foothold in the host, and in terms of the downstream disease course and likelihood of severe consequences, such as cytokine storm and multi-organ failure.”

While their findings needed validation, they allowed clinicians “some ability to risk stratify their patients and make informed decisions on appropriate levels of social isolation and shielding,” the study authors wrote.

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