Key findings from the UKCCMP cohort of 877 patients with haematological malignancy and COVID-19: disease control as an important factor relative to recent chemotherapy or anti-CD20 therapy

被引:22
作者
Booth, Stephen [1 ]
Curley, Helen M. [2 ]
Varnai, Csilla [2 ,3 ]
Arnold, Roland [2 ]
Lee, Lennard Y. W. [2 ,4 ]
Campton, Naomi A. [5 ]
Cook, Gordon [6 ]
Purshouse, Karin [7 ]
Aries, James [8 ]
Innes, Andrew [9 ]
Cook, Lucy B. [9 ]
Tomkins, Oliver [10 ]
Oram, Helen S. [10 ]
Tilby, Michael [11 ]
Kulasekararaj, Austin [12 ]
Wrench, David [13 ]
Dolly, Saoirse [13 ]
Newsom-Davies, Tom [14 ]
Pettengell, Ruth [15 ]
Gault, Abigail [16 ]
Moody, Sam [16 ]
Mittal, Sajjan [17 ]
Altohami, Mohammed [17 ]
Tillet, Tania [18 ]
Illingworth, Jack [19 ]
Mukherjee, Leena [20 ]
Apperly, Jane [9 ]
Ashcroft, John [6 ,21 ]
Rabin, Neil [22 ]
Carmichael, Jonathan [6 ]
Cazier, Jean-Baptiste [2 ,3 ]
Kerr, Rachel [4 ]
Middleton, Gary [23 ]
Collins, Graham P. [1 ]
Palles, Claire [2 ]
机构
[1] Churchill Hosp, Oxford NIHR BioMed Res Ctr, Dept Haematol, Oxford, England
[2] Univ Birmingham, Inst Canc & Genom Sci, Birmingham, England
[3] Univ Birmingham, Ctr Computat Biol, Birmingham, England
[4] Univ Oxford, Dept Oncol, Oxford, England
[5] Birmingham Hlth Partners, Inst Translat Med, Birmingham, England
[6] Univ Leeds, NIHR Leeds MIC, St James Teaching Hosp, Leeds, England
[7] Univ Edinburgh, Edinburgh Canc Res Ctr, Edinburgh, Scotland
[8] Barts Hlth NHS Trust, London, England
[9] Imperial Coll Healthcare NHS Trust, London, England
[10] Leswisham & Greenwich NHS Trust, London, England
[11] Queen Elizabeth Hosp, Birmingham, W Midlands, England
[12] Kings Coll Hosp London, Dept Haematol, London, England
[13] Guys & St Thomas NHS Fdn Trust, London, England
[14] Chelsea & Westminster Hosp NHS Fdn Trust, London, England
[15] St Georges Univ Hosp NHS Fdn Trust, London, England
[16] Newcastle Tyne NHS Fdn Trust, NCCC No Ctr Canc Care, Newcastle, England
[17] Northampton Gen Hosp NHS Trust, Northampton, England
[18] Royal United Hosp Bath, Bath, Avon, England
[19] Barking Havering & Redbridge Univ Hosp NHS Trust, Essex, England
[20] Beatson West Scotland Canc Ctr, Glasgow, Scotland
[21] Mid Yorkshire Hosp NHS Trust, Wakefield, England
[22] Univ Coll London Hosp, London, England
[23] Univ Birmingham, Inst Immunol & Immunotherapy, Birmingham, W Midlands, England
关键词
COVID-19; haematological malignancies; cancer treatments; CANCER;
D O I
10.1111/bjh.17937
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Patients with haematological malignancies have a high risk of severe infection and death from SARS-CoV-2. In this prospective observational study, we investigated the impact of cancer type, disease activity, and treatment in 877 unvaccinated UK patients with SARS-CoV-2 infection and active haematological cancer. The primary end-point was all-cause mortality. In a multivariate analysis adjusted for age, sex and comorbidities, the highest mortality was in patients with acute leukaemia [odds ratio (OR) = 1 center dot 73, 95% confidence interval (CI) 1 center dot 1-2 center dot 72, P = 0 center dot 017] and myeloma (OR 1 center dot 3, 95% CI 0 center dot 96-1 center dot 76, P = 0 center dot 08). Having uncontrolled cancer (newly diagnosed awaiting treatment as well as relapsed or progressive disease) was associated with increased mortality risk (OR = 2 center dot 45, 95% CI 1 center dot 09-5 center dot 5, P = 0 center dot 03), as was receiving second or beyond line of treatment (OR = 1 center dot 7, 95% CI 1 center dot 08-2 center dot 67, P = 0 center dot 023). We found no association between recent cytotoxic chemotherapy or anti-CD19/anti-CD20 treatment and increased risk of death within the limitations of the cohort size. Therefore, disease control is an important factor predicting mortality in the context of SARS-CoV-2 infection alongside the possible risks of therapies such as cytotoxic treatment or anti-CD19/anti-CD20 treatments.
引用
收藏
页码:892 / 901
页数:10
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