As you might expect COVID-19 had a starring role as the new villain at the 62nd Annual Meeting and Exposition of the American Society of Hematology or ASH 2020.
I interviewed Dr. Lindsey Roeker of Memorial Sloan Kettering in New York City about the research she presented: Worldwide Examination of Patients with CLL Hospitalized for COVID-19.
Dr. Roeker presented data on COVID-19 in CLL patients from 141 sites in Europe and the USA, in two cohorts, the first mostly from Europe and the second largely the USA and UK.
- 411 hospitalized CLL patients were studied.
- Symptoms were as expected:
- 88% had fever >100.3° F
- Lymphocyte counts were often abnormally either up or down
- About half were coughing and/or were short of breath
- 90% of those admitted to hospital needed supplemental oxygen
- ICU admissions varied between the two cohorts which might reflect bed availability early in the pandemic
- Mortality rate was 30-35%. For patients who do get sick enough to be hospitalized, it’s a serious disease.
- It is difficult to predict who has worse odds of dying, but age and co-morbidities increased the risk.
- There may be a suggestion that treatment with chemo-immunotherapy may also increase mortality risk.
- There was no signal if ibrutinib or acalabrutinib help or hurt outcomes, perhaps because for most on these novel agents, their medications were held.
COVID-19 is one serious infection for those who need hospitalization, and except for advancing age and maybe co-comorbidities, we aren’t very good at predicting who is at higher risk for a dangerous ride with SARS-CoV-2.
Please remember that this data are from significantly symptomatic patients. Many CLL patients may have mild or even asymptomatic disease. While potentially serious, COVID-19 is not a death sentence.
Being replete with Vitamin D seems to help the general community. Maybe zinc too.
But the best advice remains to not get sick and get the vaccine, because even it’s only partially effective, as Dr. Fauci said at the opening of ASH 2020, some immunity is better than none. And it very likely to be safe.
Here is the link to the referenced ASH abstract: Worldwide Examination of Patients with CLL Hospitalized for COVID-19.
Here is my ASH 2020 interview with Dr. Roeker through the magic of ZOOM:
Here is my article on Dr. Roeker’s related research from Leukemia: Anti-SARS-CoV-2 antibody response in patients with chronic lymphocytic leukemia.
Here is the press release from AstraZeneca on the negative acalabrutinib trial for severe COVID-19.
We are all in this together.
Brian Koffman MDCM (retired), MS Ed
Co-Founder, Executive VP and Chief Medical Officer
CLL Society, Inc.