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Br J Haematol ; 196(4): 892-901, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34761389

RESUMO

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) = 1·73, 95% confidence interval (CI) 1·1-2·72, P = 0·017] and myeloma (OR 1·3, 95% CI 0·96-1·76, P = 0·08). Having uncontrolled cancer (newly diagnosed awaiting treatment as well as relapsed or progressive disease) was associated with increased mortality risk (OR = 2·45, 95% CI 1·09-5·5, P = 0·03), as was receiving second or beyond line of treatment (OR = 1·7, 95% CI 1·08-2·67, P = 0·023). 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.


Assuntos
Antígenos CD20/imunologia , Antineoplásicos Imunológicos/uso terapêutico , COVID-19/complicações , Neoplasias Hematológicas/complicações , Neoplasias Hematológicas/tratamento farmacológico , Adulto , Antineoplásicos Imunológicos/efeitos adversos , COVID-19/etiologia , COVID-19/imunologia , Feminino , Neoplasias Hematológicas/imunologia , Humanos , Leucemia/complicações , Leucemia/tratamento farmacológico , Leucemia/imunologia , Masculino , Mieloma Múltiplo/complicações , Mieloma Múltiplo/tratamento farmacológico , Mieloma Múltiplo/imunologia , Estudos Prospectivos , Fatores de Risco
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