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Cancers (Basel) ; 13(22)2021 Nov 09.
Article in English | MEDLINE | ID: covidwho-1533799


Association of blinatumomab treatment with myelosuppression was examined in this study. Peripheral blood counts were assessed prior to, during, and after blinatumomab treatment in patients with relapsed/refractory Philadelphia chromosome-negative (Ph-) B-cell precursor (BCP) acute lymphoblastic leukemia (ALL; n = 267) and Ph+ BCP-ALL (n = 45) from the TOWER and ALCANTARA studies, respectively, or chemotherapy in patients with Ph- BCP-ALL (n = 109) from the TOWER study; all the patients with relapsed/refractory BCP-ALL and responders achieving complete remission (CR) or CR with partial/incomplete hematological recovery (CRh/CRi) were evaluated. Event-free survival (EFS) and overall survival (OS) were assessed in patients achieving CR and CRh/CRi. Median leukocyte, neutrophil, and platelet counts increased during two blinatumomab cycles but remained low longer after chemotherapy. Among the responders, there was a trend that a greater proportion of patients achieved CR with blinatumomab (Ph-, 76.5%; Ph+, 77.8%) versus with chemotherapy (Ph-, 63.6%). In the TOWER study, the survival prognosis for patients achieving CRh/CRi versus CR with blinatumomab was more similar (median OS, 11.9 (95% CI, 3.9-not estimable (NE)) vs. 15.0 (95% CI, 10.4-NE) months, p = 0.062) than with chemotherapy (5.2 (95% CI, 1.6-NE) vs. 18.9 (95% CI, 9.3-NE) months, p = 0.013). Blinatumomab treatment, with only temporary and transient myelosuppression, resulted in a greater survival benefit than chemotherapy.

Acta Haematol ; 144(2): 132-145, 2021.
Article in English | MEDLINE | ID: covidwho-237075


The coronavirus disease 2019 (COVID-19) pandemic poses several challenges to the management of patients with leukemia. The biology of each leukemia and its corresponding treatment with conventional intensive chemotherapy, with or without targeted therapies (venetoclax, FLT3 inhibitors, IDH1/2 inhibitors, Bruton's tyrosine kinase inhibitors), introduce additional layers of complexity during COVID-19 high-risk periods. The knowledge about COVID-19 is accumulating rapidly. An important distinction is the prevalence of "exposure" versus "clinical infectivity," which determine the risk versus benefit of modifying potentially highly curative therapies in leukemia. At present, the rate of clinical infection is <1-2% worldwide. With a mortality rate of 1-5% in CO-VID-19 patients in the general population and potentially of >30% in patients with cancer, careful consideration should be given to the risk of COVID-19 in leukemia. Instead of reducing patient access to specialized cancer centers and modifying therapies to ones with unproven curative benefit, there is more rationale for less intensive, yet effective therapies that may require fewer clinic visits or hospitalizations. Here, we offer recommendations on the optimization of leukemia management during high-risk COVID-19 periods.

COVID-19/complications , Leukemia/complications , Leukemia/therapy , SARS-CoV-2 , Acute Disease , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , COVID-19/epidemiology , COVID-19/prevention & control , Chronic Disease , Humans , Myelodysplastic Syndromes/complications , Myelodysplastic Syndromes/therapy , Myeloproliferative Disorders/complications , Myeloproliferative Disorders/therapy , Pandemics , Risk Factors
Non-conventional | WHO COVID | ID: covidwho-141840