Subject(s)
Blood Platelets/pathology , COVID-19/complications , Myeloproliferative Disorders/blood , Thrombocytosis/complications , Venous Thromboembolism/pathology , Aged , Aged, 80 and over , Blood Platelets/virology , COVID-19/transmission , COVID-19/virology , Female , Humans , Male , Middle Aged , Myeloproliferative Disorders/virology , Prognosis , SARS-CoV-2/isolation & purification , Thrombocytosis/pathology , Thrombocytosis/virology , Venous Thromboembolism/etiology , Venous Thromboembolism/virologySubject(s)
COVID-19 Vaccines/therapeutic use , COVID-19/immunology , Myeloproliferative Disorders/drug therapy , Myeloproliferative Disorders/immunology , Adult , Aged , Aged, 80 and over , COVID-19/genetics , COVID-19/prevention & control , COVID-19/virology , Female , Fusion Proteins, bcr-abl/genetics , Humans , Male , Middle Aged , Myeloproliferative Disorders/diagnosis , Myeloproliferative Disorders/virology , SARS-CoV-2/immunology , SARS-CoV-2/isolation & purificationSubject(s)
COVID-19/complications , Myeloproliferative Disorders/therapy , SARS-CoV-2/isolation & purification , Telemedicine/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/transmission , COVID-19/virology , Female , Follow-Up Studies , Germany/epidemiology , Humans , Male , Middle Aged , Myeloproliferative Disorders/epidemiology , Myeloproliferative Disorders/virology , Prognosis , Surveys and Questionnaires , Young AdultSubject(s)
COVID-19/immunology , Myeloproliferative Disorders/pathology , Neoplasms/immunology , T-Lymphocytes/immunology , Adult , CD8-Positive T-Lymphocytes/drug effects , CD8-Positive T-Lymphocytes/immunology , COVID-19/complications , COVID-19/diagnosis , COVID-19/virology , Case-Control Studies , Chronic Disease , Female , Health Personnel , Humans , Immunity, Cellular , Immunologic Memory/drug effects , Janus Kinase Inhibitors/pharmacology , Male , Middle Aged , Myeloproliferative Disorders/virology , Neoplasms/virology , SARS-CoV-2/genetics , SARS-CoV-2/immunologyABSTRACT
We report the clinical presentation and risk factors for survival in 175 patients with myeloproliferative neoplasms (MPN) and COVID-19, diagnosed between February and June 2020. After a median follow-up of 50 days, mortality was higher than in the general population and reached 48% in myelofibrosis (MF). Univariate analysis, showed a significant relationship between death and age, male gender, decreased lymphocyte counts, need for respiratory support, comorbidities and diagnosis of MF, while no association with essential thrombocythemia (ET), polycythemia vera (PV), and prefibrotic-PMF (pre-PMF) was found. Regarding MPN-directed therapy ongoing at the time of COVID-19 diagnosis, Ruxolitinib (Ruxo) was significantly more frequent in patients who died in comparison with survivors (p = 0.006). Conversely, multivariable analysis found no effect of Ruxo alone on mortality, but highlighted an increased risk of death in the 11 out of 45 patients who discontinued treatment. These findings were also confirmed in a propensity score matching analysis. In conclusion, we found a high risk of mortality during COVID-19 infection among MPN patients, especially in MF patients and/or discontinuing Ruxo at COVID-19 diagnosis. These findings call for deeper investigation on the role of Ruxo treatment and its interruption, in affecting mortality in MPN patients with COVID-19.
Subject(s)
COVID-19/mortality , Myeloproliferative Disorders/mortality , Pyrazoles/administration & dosage , SARS-CoV-2/isolation & purification , Withholding Treatment/statistics & numerical data , Aged , COVID-19/complications , COVID-19/transmission , COVID-19/virology , Europe/epidemiology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Myeloproliferative Disorders/drug therapy , Myeloproliferative Disorders/epidemiology , Myeloproliferative Disorders/virology , Nitriles , Prognosis , Pyrimidines , Retrospective Studies , Survival RateABSTRACT
The ongoing COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 is a global public health crisis. Multiple observations indicate poorer post-infection outcomes for patients with cancer than for the general population. Herein, we highlight the challenges in caring for patients with acute leukaemias and myeloid neoplasms amid the COVID-19 pandemic. We summarise key changes related to service allocation, clinical and supportive care, clinical trial participation, and ethical considerations regarding the use of lifesaving measures for these patients. We recognise that these recommendations might be more applicable to high-income countries and might not be generalisable because of regional differences in health-care infrastructure, individual circumstances, and a complex and highly fluid health-care environment. Despite these limitations, we aim to provide a general framework for the care of patients with acute leukaemias and myeloid neoplasms during the COVID-19 pandemic on the basis of recommendations from international experts.