Table 2.
Overview of key studies addressing the impact of hematologic malignancies on COVID-19 outcomes.
| Data Source, Reference | Population of Interest | Main Outcomes |
|---|---|---|
| Hematologic cancer registry of India [63] | 565 reports of patients of all ages from tertiary Indian centers with HM and laboratory-confirmed COVID-19 between 21 March 2020–20 March 2021 | ↑ mortality (aHR 2.85, 1.58–5.13) and severe disease (aOR 2.73, 1.45–5.12 for AML vs. ALL) No differences between AML and other hematologic diagnoses ↑ mortality among those not in remission (aOR 1.85, 1.18–2.89) No effects of corticosteroid treatment or exposure to monoclonal antibodies |
| European Hematology Association Survey [64] | 3,801 patients with HM and laboratory-confirmed COVID-19 from 132 hematology centers across Europe between March 2020–December 2020 | Highest death rates in AML (40%) and MDS (42.3%) Active malignancy associated with ↑mortality (aHR 1.86, 1.62–2.14) Among different HL diagnoses, only AML independently associated with ↑mortality (aHR 2.046, 1.18–3.56 vs. NHL) |
| Nationwide retrospective study in Israel [65] | 313 patients with HM and COVID-19 from 16 medical centers | Age > 70 years, arterial hypertension, active treatment associated with adverse outcomes Remdesivir treatment linked to ↓ mortality no effects of other treatment modalities (corticosteroids, enoxaparin, convalescent plasma) |
| Data from population-based registry in Madrid, Spain [66] | 833 patients with HM and COVID-19 from 27 medical centers between 28 February 2020 and 25 May 2020 | Overall, 62% severe/critical disease, 33% mortality (highest among AML and MDS patients, 40% and 42.3%, respectively) ↑ risk of death > 60 years, no effect of gender ↑ mortality for AML (aHR 2.22, 1.31–3.74 vs. NHL), Monoclonal antibody treatment and conventional chemotherapy (aHRs vs. nontreatment (aHRs 2.02, 1.14–3.60 and 1.50, 0.99–2.29 vs. no treatment, respectively) ↓ mortality for Ph-negative myeloproliferative disorders and treatment with hypomethylating agents (aHRs 0.33, 0.14–0.81 vs. NHL and 0.47, 0.23–0.94 vs. no treatment, respectively) |
| Case–control study from 2 Hospital in Wuhan province, China [4] | 13 cases among 128 hospitalized patients with HM and 16 HCWs with COVID-19 | ↑ mortality for those with HM vs. controls (62% vs. 0, p = 0.002) |
| Meta-analysis of 34 studies in adult and 5 in pediatric populations [67] | 3377 patients with HM from 39 studies in total | No effects of recent systemic overall antineoplastic or cytotoxic therapy (RRs 1.17, 0.83–1.64 and 1.29, 0.78–2.15 vs. no treatment, respectively) on COVID-19 mortality |
| Case control study from a nationwide database of patient electronic health records in the US [68] | 73 million patients, 517.580 with 8 types of HMs, 420 with SARS-CoV-2 infection up to 1 September 2020 | Significantly ↑ SARS-CoV-2 acquisition rates for HM vs. controls (overall aOR 11.9, 11.3–12.5 for diagnosis < 1 year, 2.3, 2.2–2.4 for prior diagnosis), highest among ALL, ET, MM, AML and lowest for PV ↑ Higher hospitalization and death rates for HM vs. non-HM |
| Prospective cohort study among patients enrolled UK Coronavirus Cancer Monitoring project [69] | 227 patients with HM (Leukemia, Lymphoma, MM, others) among 1044 with active cancer and documented SARS-CoV-2 infection between 18 March 2020–8 May 2020 |
↑ risk for adverse outcomes for HM vs. solid tumor patients (aORs for high flow oxygen therapy 1.82, 1.11–2.94, NIV 2.10, 1.14–3.76, ICU 2.73, 1.43–5.11, severe/critical disease 1.57, 1.15–2.15) ↑ in-hospital mortality for HM patients who recently received chemotherapy (1.57, 1.15–2.15 vs. no recent chemotherapy) |
Abbreviations: ALL: acute lymphocytic leukemia; AML: acute myeloid leukemia; ET; essential thrombocytopenia; NHL: non-Hodgkin lymphoma; HM: hematologic malignancy; HR; hazard ratio; MDS: myelodysplastic syndrome; MM: multiple myeloma; NIV: non-invasive ventilation; OR: odds ratio; PV: polycythemia vera; RR: relative risk.