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Observational Study
. 2021 Apr:7:577-584.
doi: 10.1200/GO.20.00620.

Treating Acute Leukemia During the COVID-19 Pandemic in an Environment With Limited Resources: A Multicenter Experience in Four Latin American Countries

Roberta Demichelis-Gómez  1 , Martha Alvarado-Ibarra  2 , Jule Vasquez-Chávez  3 , Nancy Delgado-López  4 , Cynthia Gómez-Cortés  4 , Karla Espinosa-Bautista  5 , Ana Cooke-Tapia  6 , Andrea Milán-Salvatierra  7 , Andrés Gómez-De León  8 , Yu Ling Lee-Tsai  9 , Daniel Rosales-López  10 , Álvaro Cabrera-García  11 , Fabián Amador-Medina  12 , Alejandra Córdoba-Ramírez  13 , Iván Murrieta-Álvarez  13 , Juan Carlos Solís-Poblano  14 , Elia Apodaca-Chávez  1 , Juan Rangel-Patiño  1 , José Luis Álvarez-Vera  2 , Luara Arana-Luna  2 , José Antonio De la Peña-Celaya  2 , María Eugenia Espitia-Ríos  2 , Eleazar Hernández-Ruiz  2 , Juan Manuel Pérez-Zúñiga  2 , Estefanía Peña-López  3 , Rosa González-Rivera  4 , María Fernanda García-Leyva  5 , Mónica Tejeda-Romero  7 , Jorge Cruz-Rico  7 , Carolina Balderas-Delgado  11 , Guillermo J Ruíz-Argüelles  13 , David Gómez-Almaguer  8
Affiliations
Observational Study

Treating Acute Leukemia During the COVID-19 Pandemic in an Environment With Limited Resources: A Multicenter Experience in Four Latin American Countries

Roberta Demichelis-Gómez et al. JCO Glob Oncol. 2021 Apr.

Abstract

Purpose: The COVID-19 pandemic is a colossal challenge for global health; nonetheless, specific subgroups face considerably higher risks for infection and mortality. Among patients with malignant diseases, those with hematologic neoplasms are at a higher risk for poor outcomes. The objective of this study was to register treatment modifications associated with the COVID-19 pandemic and their short-term consequences in Latin America.

Methods: Multicenter, prospective, observational, cohort study including patients older than 14 years from 14 centers in four countries (Mexico, Peru, Guatemala, and Panama) who had a confirmed diagnosis of acute leukemia, and who were undergoing active treatment since the first COVID-19 case in each country until the cutoff on July 15, 2020.

Results: We recruited 635 patients. Treatment modifications because of the COVID-19 pandemic were reported in 40.8% of cases. The main reason for such modifications was logistic issues (55.0%) and the most frequent modification was chemotherapy delay (42.0%). A total of 13.1% patients developed COVID-19 disease, with a mortality of 37.7%. Several factors were identified as independently associated with mortality, including a diagnosis of acute myeloid leukemia (odds ratio 2.38 [95% CI, 1.47 to 3.84]; P < .001), while the use of telemedicine was identified as a protective factor (odds ratio 0.36 [95% CI, 0.18 to 0.82]; P = .014).

Conclusion: These results highlight the collateral damage of COVID-19 in oncology patients.

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Conflict of interest statement

Roberta Demichelis-GómezHonoraria: AbbVie, Novartis, Amgen, Celgene/Bristol-Myers SquibbConsulting or Advisory Role: AbbVie, Novartis, Amgen, Celgene/Bristol-Myers Squibb, Jazz PharmaceuticalsSpeakers' Bureau: AbbVie, Novartis, Amgen, Celgene/Bristol-Myers SquibbResearch Funding: NovartisTravel, Accommodations, Expenses: AbbVie, Novartis Jule Vasquez-ChávezTravel, Accommodations, Expenses: Janssen Nancy Delgado-LópezConsulting or Advisory Role: Amgen, PfizerSpeakers' Bureau: Bristol-Myers Squibb (Mexico), Novartis Ana Cooke-TapiaTravel, Accommodations, Expenses: Janssen Andrés Gómez-De LeónHonoraria: Novartis, AbbVieConsulting or Advisory Role: AstraZeneca, Sanofi/Aventis Luara Arana-LunaSpeakers' Bureau: Amgen, NovartisTravel, Accommodations, Expenses: Teva José Antonio De la Peña-CelayaConsulting or Advisory Role: Janssen-Cilag, RocheSpeakers' Bureau: Janssen-Cilag, Roche, Novartis, Asofarma, Celgene/Bristol-Myers SquibbTravel, Accommodations, Expenses: Roche Eleazar Hernández-RuizSpeakers' Bureau: RocheResearch Funding: Bristol-Myers Squibb, Amgen, Roche Juan Manuel Pérez-ZúñigaConsulting or Advisory Role: Roche, Takeda, Bayer, Sanofi, Novo NordiskSpeakers' Bureau: Roche, Bristol-Myers Squibb (Mexico), Novartis, AmgenResearch Funding: AstraZeneca David Gómez-AlmaguerConsulting or Advisory Role: Celgene, Janssen, TakedaSpeakers' Bureau: Bristol-Myers Squibb (Mexico), AbbVie, Novartis, Janssen, AmgenNo other potential conflicts of interest were reported.

Figures

FIG 1
FIG 1
COVID-19 pandemic-related treatment modifications.
See this image and copyright information in PMC

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