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. 2021 Dec;35(12):3444-3454.
doi: 10.1038/s41375-021-01450-8. Epub 2021 Nov 1.

COVID-19 severity and mortality in patients with CLL: an update of the international ERIC and Campus CLL study

Thomas Chatzikonstantinou #  1   2 , Anargyros Kapetanakis #  2 , Lydia Scarfò #  3 , Georgios Karakatsoulis  2   4 , David Allsup  5 , Alejandro Alonso Cabrero  6   7 , Martin Andres  8 , Darko Antic  9   10 , Mónica Baile  11 , Panagiotis Baliakas  12   13 , Dominique Bron  14 , Antonella Capasso  15 , Sofia Chatzileontiadou  16 , Raul Cordoba  17 , Juan-Gonzalo Correa  18 , Carolina Cuéllar-García  19 , Lorenzo De Paoli  20 , Maria Rosaria De Paolis  21 , Giovanni Del Poeta  22 , Christos Demosthenous  1 , Maria Dimou  23 , David Donaldson  24 , Michael Doubek  25 , Maria Efstathopoulou  26 , Barbara Eichhorst  27 , Shaimaa El-Ashwah  28 , Alicia Enrico  29 , Blanca Espinet  30 , Lucia Farina  31 , Angela Ferrari  32 , Myriam Foglietta  33 , Henrik Frederiksen  34 , Moritz Fürstenau  27 , José A García-Marco  35 , Rocío García-Serra  36   37 , Massimo Gentile  38 , Eva Gimeno  39 , Andreas Glenthøj  40 , Maria Gomes da Silva  41 , Odit Gutwein  42   43 , Yervand K Hakobyan  44 , Yair Herishanu  45 , José Ángel Hernández-Rivas  46 , Tobias Herold  47 , Idanna Innocenti  48 , Gilad Itchaki  49 , Ozren Jaksic  50 , Ann Janssens  51 , Оlga B Kalashnikova  52 , Elżbieta Kalicińska  53 , Linda Katharina Karlsson  40 , Arnon P Kater  54 , Sabina Kersting  55 , Jorge Labrador  56 , Deepesh Lad  57 , Luca Laurenti  48   58 , Mark-David Levin  59 , Enrico Lista  60 , Alberto Lopez-Garcia  17 , Lara Malerba  61 , Roberto Marasca  62 , Monia Marchetti  63 , Juan Marquet  64 , Mattias Mattsson  12   65 , Francesca R Mauro  66 , Ivana Milosevic  67 , Fatima Mirás  68 , Marta Morawska  69   70 , Marina Motta  71 , Talha Munir  72 , Roberta Murru  73 , Carsten U Niemann  40 , Raquel Nunes Rodrigues  41 , Jacopo Olivieri  74 , Lorella Orsucci  75 , Maria Papaioannou  16 , Miguel Arturo Pavlovsky  76 , Inga Piskunova  77 , Viola Maria Popov  78 , Francesca Maria Quaglia  79 , Giulia Quaresmini  80 , Kristian Qvist  81 , Gianluigi Reda  82 , Gian Matteo Rigolin  83 , Rosa Ruchlemer  84 , Gevorg Saghumyan  44 , Amit Shrestha  85 , Martin Šimkovič  86 , Martin Špaček  87 , Paolo Sportoletti  88 , Oana Stanca  89 , Niki Stavroyianni  1 , Tamar Tadmor  90 , Doreen Te Raa  91 , Sanne H Tonino  92 , Livio Trentin  93 , Ellen Van Der Spek  94 , Michel van Gelder  95 , Roel van Kampen  96 , Marzia Varettoni  97 , Andrea Visentin  93 , Candida Vitale  98 , Ewa Wasik-Szczepanek  99 , Tomasz Wróbel  53 , Lucrecia Yáñez San Segundo  100 , Mohamed Yassin  101 , Marta Coscia  98 , Alessandro Rambaldi  80   102 , Emili Montserrat  18 , Robin Foà  66 , Antonio Cuneo  83 , Kostas Stamatopoulos  103 , Paolo Ghia #  104
Affiliations

COVID-19 severity and mortality in patients with CLL: an update of the international ERIC and Campus CLL study

Thomas Chatzikonstantinou et al. Leukemia. 2021 Dec.

Abstract

Patients with chronic lymphocytic leukemia (CLL) may be more susceptible to Coronavirus disease 2019 (COVID-19) due to age, disease, and treatment-related immunosuppression. We aimed to assess risk factors of outcome and elucidate the impact of CLL-directed treatments on the course of COVID-19. We conducted a retrospective, international study, collectively including 941 patients with CLL and confirmed COVID-19. Data from the beginning of the pandemic until March 16, 2021, were collected from 91 centers. The risk factors of case fatality rate (CFR), disease severity, and overall survival (OS) were investigated. OS analysis was restricted to patients with severe COVID-19 (definition: hospitalization with need of oxygen or admission into an intensive care unit). CFR in patients with severe COVID-19 was 38.4%. OS was inferior for patients in all treatment categories compared to untreated (p < 0.001). Untreated patients had a lower risk of death (HR = 0.54, 95% CI:0.41-0.72). The risk of death was higher for older patients and those suffering from cardiac failure (HR = 1.03, 95% CI:1.02-1.04; HR = 1.79, 95% CI:1.04-3.07, respectively). Age, CLL-directed treatment, and cardiac failure were significant risk factors of OS. Untreated patients had a better chance of survival than those on treatment or recently treated.

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Conflict of interest statement

LS received advisory boards fees from AbbVie and Janssen; educational activity AstraZeneca. DAl received funding to attend symposia from Gilead and Bayer. MA received advisory boards fees from AbbVie, AstraZeneca, and Janssen-Cilag; travel support from AbbVie, and Novartis. DAn received honoraria from AbbVie, Janssen, and Roche. PB has received honoraria from Abbvie, Gilead and Janssen and research funding from Gilead. RC received speaker fees from Roche, Janssen, AbbVie, AstraZeneca, Celgene, BMS, Kite, and Takeda; received advisory board fees from Janssen, AbbVie, Celgene, BMS, Kite, Takeda, Incyte, Kyowa-Kirin, and ADCT; received travel and accommodation expenses from Roche, Janssen, AbbVie, Celgene, BMS, Kite, Takeda, and Pfizer; research grant from Pfizer. MD received honoraria for advisory board and research support from AstraZeneca, AbbVie, Roche, Gilead, and Janssen. BEi received consulting or advisory boards fees from Janssen, Roche, Novartis, AbbVie, Gilead, Celgene, ArQule, AstraZeneca, Oxford Biomedica (UK), and BeiGene; speaker/speaker’s bureau fees from Janssen, Gilead, Roche, AbbVie, Novartis, Celgene, Adaptive Biotechnologies, BioGene, and AstraZeneca; research support/research funding from Janssen, Gilead, Roche, AbbVie, BeiGene, and AstraZeneca; travel, accommodations, expenses from Janssen, Roche, Novartis, AbbVie, Gilead, and Celgene. MF received honoraria from Janssen and Gilead. JAG-M received honoraria for advisory board and speaker´s bureau from Mundipharma, Glaxo, AbbVie, Roche, Gilead, AstraZeneca, and Janssen; research support from Hoffman-La Roche, AbbVie, and Janssen. RG-S received educational grants from AbbVie, Janssen, and Novartis. EG received travel grants, honoraria as a consultant and/or speaker bureau for Janssen-Cilag, Roche, and AbbVie. MGDS received honoraria for consultancy/advisory boards with Roche, Janssen Cilag, Gilead, AbbVie, and BMS; research Grant from Gilead. YH received honoraria from AbbVie, Janssen, AstraZeneca, and Roche, outside the submitted work. JAH-R received honoraria and advisory boards fees from Janssen, AbbVie, AstraZeneca, Roche, Beigene, Gilead, and BMS-Celgene. OJ received honoraria from AbbVie, Janssen, and Roche. APK received honoraria from Janssen, BMS, AstraZeneca, Roche/Genentech; research money from Janssen, BMS, AstraZeneca, and Roche/Genentech. SK received Travel grant from Celgene; received research funding from Janssen and AbbVie. LL received honoraria from Roche, AbbVie, Janssen, and AstraZeneca. M-DL received travel expenses and advisory board compensation from Janssen, AbbVie, and Roche. AL-G received speaker’s bureau fees from Roche, Janssen, AbbVie, Celgene, Fresenius, Novonordisk; received advisory board participation fees from Janssen, and AbbVie; received travel and accommodation expenses from Roche, Janssen, and AbbVie. MMar received speaker bureau (invited speech) fees from Amgen; received honoraria as a consultant from Gilead. JM received honoraria and travel grants from AbbVie, Janssen, Roche, Gilead, and Takeda. MMat received research grant from GILEAD. FRM received research funding from Gilead; received advisory board participation fees from AbbVie, Gilead, Janssen, AstraZeneca, Takeda, and Roche; received speakers bureau fees from Gilead, Janssen, and AbbVie. TM received honoraria from AbbVie, Janssen, AstraZeneca, Gilead, Roche, and Alexion; received advisory board participation fees from AbbVie, AstraZeneca, Janssen, Alexion, Morphosys, and Sunesis. RM received honoraria from Janssen, and AbbVie. CUN received research funding and/or consultancy fees from AbbVie, AstraZeneca, Janssen, CSL Behring, and Takeda. MAP received advisory board participation fees from Janssen, AbbVie, AstraZeneca, and Merck; received speaker’s bureau fees from Janssen, AbbVie, AstraZeneca, Varifarma, and Merck. FMQ received advisory board participation fees from AstraZeneca and Janssen; received speakers bureau fees from Janssen. GR received consultancy fees and honoraria from AbbVie, AstraZeneca, and Janssen. GMR received honoraria from AbbVie, Gilead, and Janssen; received research funding from Gilead. MŠi received consultancy fees, advisory board participation fees, travel grants, and honoraria from Janssen, Gilead, Roche, AstraZeneca, and AbbVie. MŠp received honoraria from AbbVie, AstraZeneca, Gilead, Janssen, and Roche. PS received funding from Gilead; received advisory board participation fees from AbbVie and Janssen; received honorarium AbbVie, Janssen, and AstraZeneca. LT received advisory board participation fees from Janssen, Roche, AbbVie, Gilead, Takeda; research funding from Janssen, Roche, Takeda, and Gilead. EVDS participated in teaching activities for Amgen. MV received advisory board participation fees from Janssen, Roche, AstraZeneca; received travel expenses from Janssen and AbbVie. AV received speaker’s bureau fees from Italfarmaco and Gilead; received advisory board participation fees from Janssen and Takeda. CV received honoraria from Janssen. TW received research funding from Roche; received honoraria for advisory board, and research funding from Janssen; received honoraria, advisory board participation fees, and travel grant from AbbVie; received speaker’s bureau fees from Gilead. LYSS received advisory board participation fees from Gilead-Kite, Janssen, AbbVie, AstraZeneca, Beigene, Roche, Pfizer, Jazz, BMS, and Merck; received speaker’s bureau fees from Janssen, AbbVie, AstraZeneca, Gilead-Kite, Roche, Pfizer, and Merck. MC received honoraria from AbbVie, Gilead, Janssen, and AstraZeneca. AC received speaker’s bureau and advisory board fees from AbbVie, AstraZeneca, Gilead, and Janssen. RF received speaker’s bureau fees and/or advisory board participation fees from Amgen, Incyte, Janssen, Pfizer, AbbVie, Novartis, Servier, AstraZeneca, ACu received speaker’s bureau fees and advisory board participation fees from Abbvie, Asta-Zeneca, Gilead, Janssen KS received honoraria and research support from Janssen, Abbvie, AstraZeneca, Gilead. PG received honoraria from AbbVie, Arqule/MSD, AstraZeneca, Celgene/Juno/BMS, Janssen, Loxo/Lilly, Roche; Research support, AbbVie, AstraZeneca, Janssen, Gilead, Sunesis. TC, AK, GK, AAC, MB, DB, ACa, SC, J-GC, CC-G, LDP, MRDP, GDP, CD, MDi, DD, ME, SE-A, AE, BEs, LF, AF, HF, MFü, MG, AG, OG, YKH, TH, II, GI, AJ, OBK, EK, LKK, JL, DL, EL, LM, RM, IM, FM, MMor, MMot, RNR, JO, LO, MP, IP, VMP, GQ, KQ, RR, GS, AS, OS, NS, TT, DTR, SHT, MVG, RVK, EWS, MY, AR, EM have no conflict of interest to disclose.

Figures

Fig. 1
Fig. 1. Overall survival in patients with severe COVID-19.
Overall survival comparison between treated and untreated patients with CLL and severe COVID-19.
Fig. 2
Fig. 2. Overall survival in patients with severe COVID-19 according to treatment.
Overall survival comparisons between patients treated with BTKi (at time of COVID-19), Venetoclax (at time of COVID-19), Chemoimmunotherapy in last 12 months, and Untreated.
See this image and copyright information in PMC

Comment in

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