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Determinants of outcome in Covid-19 hospitalized patients with lymphoma: A retrospective multicentric cohort study.
Lamure, Sylvain; Duléry, Rémy; Di Blasi, Roberta; Chauchet, Adrien; Laureana, Cécile; Deau-Fischer, Bénédicte; Drenou, Bernard; Soussain, Carole; Rossi, Cédric; Noël, Nicolas; Choquet, Sylvain; Bologna, Serge; Joly, Bertrand; Kohn, Milena; Malak, Sandra; Fouquet, Guillemette; Daguindau, Etienne; Bernard, Sophie; Thiéblemont, Catherine; Cartron, Guillaume; Lacombe, Karine; Besson, Caroline.
  • Lamure S; Département d'Hématologie Clinique, CHU de Montpellier, UMR-CNRS 5535, Université de Montpellier, Montpellier, France.
  • Duléry R; Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, Assistance Publique - Hôpitaux de Paris, Inserm UMRs 938, Sorbonne Université, Paris, France.
  • Di Blasi R; Service d'Hématologie-Oncologie, Hôpital St Louis, Assistance Publique - Hôpitaux de Paris ; Université de Paris - Diderot, Paris, France.
  • Chauchet A; Service d'Hématologie, CHRU de Besançon, Besançon, France.
  • Laureana C; Service d'Hématologie Oncologie, Centre Hospitalier de Versailles, 177, rue de Versailles, 78157 Le Chesnay Cedex, France.
  • Deau-Fischer B; Service d'Hématologie Clinique, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France.
  • Drenou B; Département d'Hématologie Groupe Hospitalier de Mulhouse Sud Alsace, Mulhouse, France.
  • Soussain C; Département d'Oncologie médicale - Hématologie, Institut Curie, Saint Cloud, France.
  • Rossi C; Service d'Hématologie Clinique, CHU de Dijon Bourgogne, Dijon, France.
  • Noël N; Service de Médecine Interne - Immunologie, Hôpital Bicêtre, Assistance Publique - Hôpitaux de Paris, Le Kremlin-Bicêtre, France.
  • Choquet S; Service d'Hématologie Clinique, Hôpital Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, Paris, France.
  • Bologna S; Service d'Hématologie, Centre d'Oncologie de Gentilly, Nancy, France.
  • Joly B; Service d'Hématologie, Centre Hospitalier Sud Francilien, Corbeil-Essonnes, France.
  • Kohn M; Service d'Hématologie Oncologie, Centre Hospitalier de Versailles, 177, rue de Versailles, 78157 Le Chesnay Cedex, France.
  • Malak S; Département d'Oncologie médicale - Hématologie, Institut Curie, Saint Cloud, France.
  • Fouquet G; Service d'Hématologie Clinique, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France.
  • Daguindau E; Service d'Hématologie, CHRU de Besançon, Besançon, France.
  • Bernard S; Service d'Hématologie-Oncologie, Hôpital St Louis, Assistance Publique - Hôpitaux de Paris ; Université de Paris - Diderot, Paris, France.
  • Thiéblemont C; Service d'Hématologie-Oncologie, Hôpital St Louis, Assistance Publique - Hôpitaux de Paris ; Université de Paris - Diderot, Paris, France.
  • Cartron G; Département d'Hématologie Clinique, CHU de Montpellier, UMR-CNRS 5535, Université de Montpellier, Montpellier, France.
  • Lacombe K; Sorbonne Université, Inserm IPLESP, Service des Maladies Infectieuses et Tropicales, Hôpital Saint Antoine, Assistance Publique - Hôpitaux de Paris, Paris, France.
  • Besson C; Service d'Hématologie Oncologie, Centre Hospitalier de Versailles, 177, rue de Versailles, 78157 Le Chesnay Cedex, France.
EClinicalMedicine ; 27: 100549, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-856647
ABSTRACT

BACKGROUND:

Patients with lymphoma are immunocompromised because of the disease per se and its treatments. We aimed to describe the characteristics of patients with lymphoma hospitalized for Coronavirus Disease 2019 (Covid-19) and to analyze pre-Covid-19 determinants of mortality.

METHODS:

This retrospective multicentric cohort study used the Programme de Médicalisation des Systèmes d'Information database to identify all adult patients with lymphoma, hospitalized for Covid-19 in March and April 2020, in 12 hospitals of three French regions with pandemic outbreaks. The characteristics of lymphoma and Covid-19 were collected from medical charts.

FINDINGS:

Eighty-nine patients were included. The median age was 67 years (range, 19-92), 66% were male and 72% had a comorbidity. Most patients had B-cell non-Hodgkin lymphoma (86%) and had received a lymphoma treatment within one year (70%). With a median follow-up of 33 days from admission, 30-day overall survival was 71%, (95% confidence interval, 62-81%). In multivariable analysis, having an age ≥ 70 years (hazard ratio 2·87, 1·20-6·85, p = 0·02) and relapsed/refractory lymphoma (hazard ratio 2·54, 1·14-5·66, p = 0·02) were associated with mortality. Recent bendamustine treatment (n = 9) was also pejorative (hazard ratio 3·20, 1·33-7·72, p = 0·01), but was strongly associated with relapsed/refractory lymphoma. Remarkably, 30-day overall survival for patients < 70 years of age without relapsed/refractory lymphoma was 88% (78% - 99%).

INTERPRETATION:

Thirty-day mortality was associated with being older and relapsed/refractory lymphoma. Survival of patients younger than 70 years without relapsed/refractory lymphoma was comparable to that of the general population.

FUNDING:

There have been no specific funds to run this study.

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: EClinicalMedicine Year: 2020 Document Type: Article Affiliation country: J.eclinm.2020.100549

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: EClinicalMedicine Year: 2020 Document Type: Article Affiliation country: J.eclinm.2020.100549