Patients with acute myeloid leukemia (AML) are at high risk of dying from coronavirus disease 2019 (COVID-19). The optimal management of AML patients with COVID-19 has not been established. Our multicenter study included 388 adult AML patients diagnosed with COVID-19 between February 2020 and October 2021. The vast majority were receiving or had received AML treatment in the preceding 3 months. COVID-19 was severe in 41.2% and critical in 21.1% of cases. The chemotherapeutic schedule was modified in 174 patients (44.8%), delayed in 68 and permanently discontinued in 106. After a median follow-up of 325 days, 180 patients (46.4%) had died; death was attributed to COVID-19 (43.3%), AML (26.1%) or to a combination of both (26.7%), whereas in 3.9% of cases the reason was unknown. Active disease, older age, and treatment discontinuation were associated with death, whereas AML treatment delay was protective. Seventy-nine patients had a simultaneous AML and COVID-19 diagnosis, with better survival when AML treatment could be delayed (80%; P<0.001). Overall survival in patients with a diagnosis of COVID-19 between January 2020 and August 2020 was significantly lower than that in patients diagnosed between September 2020 and February 2021 and between March 2021 and September 2021 (39.8% vs. 60% vs. 61.9%, respectively; P=0.006). COVID-19 in AML patients was associated with a high mortality rate and modifications of therapeutic algorithms. The best approach to improve survival was to delay AML treatment, whenever possible.

Aga Khan University Hospital Karachi

Amsterdam UMC location VUmc Amsterdam

AOU Sant'Andrea Rome

AOUP Azienda Ospedaliera Università Pisana Cisanello Pisa

ASST Grande Ospedale Metropolitano Niguarda Milan

Azerbaijan Scientific Research Hematology and Transfusilogy Institute Baku

Azienda Ospedaliera Nazionale SS Antonio e Biagio e Cesare Arrigo Alessandria

Azienda Ospedaliera San Gerardo Monza Monza Italy Università Milano Bicocca Milan

Centro Hospitalar e Universitário São João Porto

Clinical Microbiology and Infectious Diseases Department Hospital General Universitario Gregorio Marañón Madrid

Complejo Hospitalario de Navarra Iruña Pamplona

Département d'Hématologie Clinique CHU de Montpellier UMR CNRS 5535 Universite de Montpellier Montpellier

Department of Clinical Haematology Yangon General Hospital University of Medicine Yangon

Department of Haematology Blood Neoplasms and Bone Marrow Transplantation Wroclaw Medical University Wroclaw

Department of Hematological Medicine Kings College Hospital NHS Foundation Trust London

Department of Hematology and Oncology Medical University of Innsbruck Innsbruck

Department of Hematology and Oncology University Hospital Pilsen Czech Republic Department of Histology and Embryology Faculty of Medicine Pilsen Czech Republic

Department of Hematology Copenhagen University Hospital Rigshospitalet Copenhagen

Department of Hematology University Hospital Virgen Macarena University Hospital Virgen del Rocío Instituto de Biomedicina de Sevilla Seville

Department of Hematology Vall d'Hebron Hospital Universitari Experimental Hematology Vall d'Hebron Institute of Oncology Vall d'Hebron Barcelona Hospital Campus Barcelona Spain Departament de Medicina Universitat Autònoma de Barcelona Bellaterra

Department of Infectious Diseases Hospital Clinic de Barcelona University of Barcelona IDIBAPS Barcelona

Department of Infectious Diseases Karolinska University Hospital Stockholm

Department of Internal Medicine Federal University of Rio de Janeiro Rio de Janeiro

Department of Internal Medicine South Division Faculty of Medicine University of Szeged Szeged

Department of Medicine and Surgery University of Insubria and ASST Sette Laghi Ospedale di Circolo of Varese Varese

Department of Medicine Section of Hematology University of Verona Verona

Department of Microbiology Immunology and Transplantation KULeuven Leuven and Department of Hematology UZ Leuven Leuven

Department of Nephrology and Infectious diseases AZ Sint Jan Brugge Oostende AV Brugge

Department of Oncology Hematology and Bone Marrow Transplantation with Section of Pneumology University Medical Center Hamburg Eppendorf Hamburg

Division of Infectious Diseases and Global Public Health Department of Medicine University of California San Diego San Diego CA United States Clinical and Translational Fungal Working Group University of California San Diego La Jolla CA United States Division of Infectious Diseases Department of Internal Medicine Medical University of Graz Graz

Division of Infectious Diseases and Hospital Epidemiology and Department of Clinical Research University and University Hospital of Basel Basel

Dokuz Eylul University Division of Hematology Izmir

Ematologia con Trapianto Ospedale Dimiccoli Barletta Barletta

Fundacion Jimenez Diaz University Hospital Health Research Institute IIS FJD Madrid

Gomel State Medical University Gomel

Hamad Medical Corporation Division of Infectious Diseases Doha

Head of the ICU and Transplant Unit Department of Hematooncology University Hospital of Ostrava Ostrava Poruba Czech Republic

Hematology and Stem Cell Transplant Unit IRCCS Regina Elena National Cancer Institute Rome

Hematology Department Hospital Universitario de Salamanca Salamanca Spain IBSAL Centro de Investigación del Cáncer IBMCC Salamanca

Hematology Unit ASST Spedali Civili Brescia

Hematology Unit Department of Biomedicine and Prevention Tor Vergata University of Rome

Hematology Unit Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan

Hematology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome

Hematology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome Italy Hematology Unit Università Cattolica del Sacro Cuore Rome

Hospital Escuela de Agudos Dr Ramón Madariaga Posadas

Hospital Universitario 12 de Octubre Madrid

Hospital Universitario Marqués de Valdecilla Santander

Hospital Univesitario Virgen del Rocío Seville

ICANS Strasbourg

Institute of Hematology and Blood Transfusion Prague Czech Republic

Institute of Hematology and Blood Transfusion Prague Czech Republic Department of Physiology Faculty of Medicine Masaryk University Brno Czech Republic; IRCCS Ospedale San Raffaele Milan

IRCCS Ospedale San Raffaele Milan

King's College Hospital London

La Paz University Hospital Madrid

Medical University of Graz Department for Infectious Diseases Graz

North Western State Medical University named after Iliá Ilich Méchnikov Saint Petersburg

Oncology Center Mansoura University Mansoura

Ospedale San Bortolo Vicenza

Oxford University Hospitals Oxford

Portuguese Institute of Oncology Lisbon

RM Gorbacheva Research Institute Pavlov University St Petersburg

Stem Cell Transplant Center AOU Citta' della Salute e della Scienza Turin

Sultan Qaboos University Hospital Muscat

Universitätsklinikum Hamburg Eppendorf Hamburg Germany University of Cologne Faculty of Medicine and University Hospital Cologne Department 1 of Internal Medicine Excellence Center for Medical Mycology Cologne

University Hospital Brno Department of Internal Medicine Hematology and Oncology Brno Czech Republic

University Hospital Centre Zagreb Zagreb Croatia Croatian Cooperative Group for Hematological Diseases Croatia Faculty of Medicine University of Zagreb Zagreb Croatia

University Hospital Dubrava Zagreb Croatia

University Hospital Hradec Králové Hradec Králové Czech Republic

University Hospital Olomouc Olomouc Czech Republic

University Hospital Pilsen Pilsen Czech Republic

University Medical Center Groningen Groningen

University of Cologne Faculty of Medicine and University Hospital Cologne Department 1 of Internal Medicine Excellence Center for Medical Mycology Cologne

University of Cologne Faculty of Medicine and University Hospital Cologne Department 1 of Internal Medicine Excellence Center for Medical Mycology Partner Site Bonn Cologne Cologne

University of Kansas Medical Center Kansas City

University of Milan and Fondazione IRCCS Istituto Nazionale dei Tumori Milan

UOC Hematology AORN Cardarelli Naples

Zobrazit více v PubMed

Döhner H, Estey E, Grimwade D, et al. . Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel. Blood. 2017;129(4):424-447. PubMed PMC

Ferrara F, Schiffer C. Acute myeloid leukaemia in adults. Lancet. 2013;381(9865):484-495. PubMed

Fontana L, Strasfeld L. Respiratory virus infections of the stem cell transplant recipient and the hematologic malignancy patient. Infect Dis Clin North Am. 2019;33(2):523-544. PubMed PMC

Pagano L, Salmanton-García J, Marchesi F, et al. . COVID-19 infection in adult patients with hematologic malignancies: a European Hematology Association survey (EPICOVIDEHA). J Hematol Oncol. 2021;14(1):168. PubMed PMC

Passamonti F, Cattaneo C, Arcaini L, et al. . Clinical characteristics and risk factors associated with COVID-19 severity in patients with hematological malignancies in Italy: a retrospective, multicentre, cohort study. Lancet Haematol. 2020;7(10):e737-e745. PubMed PMC

García-Suárez J, de la Cruz J, Cedillo Á, et al. . Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry study. J Hematol Oncol. 2020;13(1):133. PubMed PMC

Vijenthira A, Gong IY, Fox TA, et al. . Outcomes of patients with hematologic malignancies and COVID-19: a systematic review and meta-analysis of 3377 patients. Blood. 2020;136(25):2881-2892. PubMed PMC

Lee LYW, Cazier JB, Starkey T, et al. . COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort study. Lancet Oncol. 2020;21(10):1309-1316. PubMed PMC

Palanques-Pastor T, Megías-Vericat JE, Martínez P, et al. . Characteristics, clinical outcomes, and risk factors of SARS-COV-2 infection in adult acute myeloid leukemia patients: experience of the PETHEMA group. Leuk Lymphoma. 2021;62(12):2928-2938. PubMed

Fagundes EM, Neto NN, Caldas LM, et al. . Mortality by COVID-19 in adults with acute myeloid leukemia: a survey with hematologists in Brazil. Ann Hematol 2021;101(4):923-925. PubMed PMC

Ghandili S, Pfefferle S, Roedl K, et al. . Challenges in treatment of patients with acute leukemia and COVID-19: a series of 12 patients. Blood Adv. 2020;4(23):5936-5941. PubMed PMC

Taurino D, Frigeni M, Grassi A, et al. . Concurrent diagnosis of acute myeloid leukemia and symptomatic COVID-19 infection: a case report successfully treated with azacitidine-venetoclax combination. Mediterr J Hematol Infect Dis. 2021;13(1):e2021057. PubMed PMC

Ferrara F, Zappasodi P, Roncoroni E, Borlenghi E, Rossi G. Impact of COVID-19 on the treatment of acute myeloid leukemia. Leukemia. 2020;34(8):2254-2256. PubMed PMC

Núñez-Torrón C, García-Gutiérrez V, Tenorio-Núñez MC, Moreno-Jiménez G, López-Jiménez FJ, Herrera-Puente P. Poor outcome in patients with acute leukemia on intensive chemotherapy and COVID-19. Bone Marrow Transplant. 2021;56(1):267-269. PubMed PMC

Singh S, Singh J, Paul D, Jain K. Treatment of acute leukemia during COVID-19: focused review of evidence. Clin Lymphoma Myeloma Leuk. 2021;21(5):289-294. PubMed PMC

Demichelis-Gómez R, Alvarado-Ibarra M, Vasquez-Chávez J, et al. . Treating acute leukemia during the COVID-19 pandemic in an environment with limited resources: a multicenter experience in four Latin American countries. JCO Glob Oncol. 2021;7:577-584. PubMed PMC

Buyuktas D, Acar K, Sucak G, et al. . COVID-19 infection in patients with acute leukemia: Istanbul experience. Al J Blood Res. 2021;11(4):427-437. PubMed PMC

Salmanton-García J, Busca A, Cornely OA, et al. . EPICOVIDEHA: a ready to use platform for epidemiological studies in hematological patients with COVID-19. Hemasphere. 2021;5(7):e612. PubMed PMC

Tivian XI, Gmb H. Experience-management software. https://www.tivian.com/de/. Accessed December 28, 2021.

COVID-19 clinical management. Living guidance World Health Organization. January 15, 2021. WHO/2019-nCoV/clinical/2021.1.

Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-1242. PubMed

Zeidan AM, Boddu PC, Patnaik MM, et al. . Special considerations in the management of adult patients with acute leukaemias and myeloid neoplasms in the COVID-19 era: recommendations from a panel of international experts. Lancet Haematol. 2020;7(8):e601-e612. PubMed PMC

Raza A, Assal A, Ali AM, Jurcic JG. Rewriting the rules for care of MDS and AML patients in the time of COVID-19. Leuk Res Rep. 2020;13:100201. PubMed PMC

Yarza R, Bover M, Paredes D, et al. . SARS-CoV-2 infection in cancer patients undergoing active treatment: analysis of clinical features and predictive factors for severe respiratory failure and death. Eur J Cancer. 2020;135:242-250. PubMed PMC

Ljungman P, de la Camara R, Mikulska M, et al. . COVID-19 and stem cell transplantation; results from an EBMT and GETH multicenter prospective survey. Leukemia. 2021;35(10):2885-2894. PubMed PMC

Piñana JL, Martino R, García-García I, et al. . Risk factors and outcome of COVID-19 in patients with hematological malignancies. Exp Hematol Oncol. 2020;9:21. PubMed PMC

Stahl M, Narendra V, Jee J, et al. . Neutropenia in adult acute myeloid leukemia patients represents a powerful risk factor for COVID-19 related mortality. Leuk Lymphoma. 2021;62(8):1940-1948. PubMed PMC

Röllig C, Kramer M, Schliemann C, et al. . Does time from diagnosis to treatment affect the prognosis of patients with newly diagnosed acute myeloid leukemia? Blood. 2020;136(7):823-830. PubMed

Pagano L, Salmanton-García J, Marchesi F, et al. . COVID-19 in vaccinated adult patients with hematological malignancies. Preliminary results from EPICOVIDEHA. Blood. 2022;139(10):1588-1592. PubMed PMC

Respiratory Viruses in Patients With Hematological Malignancy in Boreal Autumn/Winter 2023-2024: EPICOVIDEHA-EPIFLUEHA Report

Need for ICU and outcome of critically ill patients with COVID-19 and haematological malignancies: results from the EPICOVIDEHA survey

Decoding the historical tale: COVID-19 impact on haematological malignancy patients-EPICOVIDEHA insights from 2020 to 2022

Simultaneous Onset of Haematological Malignancy and COVID: An Epicovideha Survey