Hematology Departments of Institut Català d'Oncologia-Hospital Germans Trias i Pujol. Josep Carreras Research Institute. Badalona. Universitat Autònoma de Barcelona, Spain.
Hematology Departments of Institut Català d'Oncologia-Hospital Germans Trias i Pujol. Josep Carreras Research Institute. Badalona. Universitat Autònoma de Barcelona, Spain.
Clin Lymphoma Myeloma Leuk. 2021 Oct;21(10):e801-e809. doi: 10.1016/j.clml.2021.06.024. Epub 2021 Jul 18.
SARS-CoV-2 infection has bimodal distribution in Europe with a first wave in March to June 2020 and a second in September 2020 to February 2021. We compared the frequency, clinical characteristics and outcomes of adults with acute lymphoblastic leukemia (ALL) and infection in the first vs. second pandemic waves in Spain.
In this prospective study the characteristics of ALL and COVID-19 infection, comorbidities, treatment and outcome in the two periods were compared. The study ended when vaccination against SARS-CoV-2 was implemented in Spain.
Twenty eight patients were collected in the first wave and 24 in the second. The median age was 46.5 years (range 20-83). Patients from the first wave had a trend to more severe ALL (higher frequency of patients under induction or submitted to transplantation or under immunosuppressive therapy). No significant differences were observed in need for oxygen support, intensive care unit (ICU) requirement, days in ICU and time to COVID-19 infection recovery. Seventeen patients (33%) died, with death attributed to COVID infection in 15 (29%), without significant differences in the 100 day overall survival (OS) probabilities in the two waves (68% ± 17% vs. 56% ± 30%). The only prognostic factor for OS identified by was the presence of comorbidities at COVID-19 infection (HR: 5.358 [95% CI: 1.875- 15.313]).
The frequency and mortality of COVID-19 infection were high in adults with ALL, without changes over time, providing evidence in favor of vaccination priority for these patients.
SARS-CoV-2 感染在欧洲呈双峰分布，2020 年 3 月至 6 月和 2020 年 9 月至 2021 年 2 月分别出现了第一波和第二波疫情。我们比较了西班牙第一波和第二波大流行期间急性淋巴细胞白血病（ALL）成人患者感染的频率、临床特征和结局。
在这项前瞻性研究中，我们比较了两个时期 ALL 和 COVID-19 感染、合并症、治疗和结局的特征。当西班牙开始接种 SARS-CoV-2 疫苗时，研究结束。
第一波收集了 28 例患者，第二波收集了 24 例。中位年龄为 46.5 岁（范围 20-83）。第一波患者的 ALL 病情更严重（诱导或接受移植或接受免疫抑制治疗的患者比例更高）。两组患者在需要吸氧支持、入住重症监护病房（ICU）、入住 ICU 天数和 COVID-19 感染恢复时间方面无显著差异。17 例患者（33%）死亡，15 例（29%）死亡归因于 COVID 感染，两个波次的 100 天总生存（OS）概率无显著差异（68%±17%vs.56%±30%）。唯一识别出的 OS 预后因素是 COVID-19 感染时存在合并症（HR：5.358[95%CI：1.875-15.313]）。
ALL 成人 COVID-19 感染的频率和死亡率均较高，且随时间无变化，这为这些患者接种疫苗提供了优先证据。
