Full Text:   <371>

Summary:  <152>

CLC number: R73; R511

On-line Access: 2020-12-09

Received: 2020-08-02

Revision Accepted: 2020-09-16

Crosschecked: 2020-11-11

Cited: 0

Clicked: 2464

Citations:  Bibtex RefMan EndNote GB/T7714

-   Go to

Article info.
Open peer comments

Journal of Zhejiang University SCIENCE B 2020 Vol.21 No.12 P.921-939

http://doi.org/10.1631/jzus.B2000423


Weathering the storm: COVID-19 infection in patients with hematological malignancies


Author(s):  Lin-qin Wang, Elaine Tan Su Yin, Guo-qing Wei, Yong-xian Hu, Arnon Nagler, He Huang

Affiliation(s):  Bone Marrow Transplantation Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China; more

Corresponding email(s):   huyongxian2000@aliyun.com, Arnon.Nagler@sheba.health.gov.il, huanghe@zju.edu.cn

Key Words:  Coronavirus disease 2019 (COVID-19), Hematological malignancies, Immunosuppressive status, Management strategies, Treatment regimen


Share this article to: More |Next Article >>>

Lin-qin Wang, Elaine Tan Su Yin, Guo-qing Wei, Yong-xian Hu, Arnon Nagler, He Huang. Weathering the storm: COVID-19 infection in patients with hematological malignancies[J]. Journal of Zhejiang University Science B, 2020, 21(12): 921-939.

@article{title="Weathering the storm: COVID-19 infection in patients with hematological malignancies",
author="Lin-qin Wang, Elaine Tan Su Yin, Guo-qing Wei, Yong-xian Hu, Arnon Nagler, He Huang",
journal="Journal of Zhejiang University Science B",
volume="21",
number="12",
pages="921-939",
year="2020",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B2000423"
}

%0 Journal Article
%T Weathering the storm: COVID-19 infection in patients with hematological malignancies
%A Lin-qin Wang
%A Elaine Tan Su Yin
%A Guo-qing Wei
%A Yong-xian Hu
%A Arnon Nagler
%A He Huang
%J Journal of Zhejiang University SCIENCE B
%V 21
%N 12
%P 921-939
%@ 1673-1581
%D 2020
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B2000423

TY - JOUR
T1 - Weathering the storm: COVID-19 infection in patients with hematological malignancies
A1 - Lin-qin Wang
A1 - Elaine Tan Su Yin
A1 - Guo-qing Wei
A1 - Yong-xian Hu
A1 - Arnon Nagler
A1 - He Huang
J0 - Journal of Zhejiang University Science B
VL - 21
IS - 12
SP - 921
EP - 939
%@ 1673-1581
Y1 - 2020
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B2000423


Abstract: 
The coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Within a matter of months, this highly contagious novel virus has led to a global outbreak and is still spreading rapidly across continents. In patients with COVID-19, underlying chronic diseases and comorbidities are associated with dismal treatment outcomes. Owing to their immunosuppressive status, patients with hematological malignancies (HMs) are at an increased risk of infection and have a worse prognosis than patients without HMs. Accordingly, intensive attention should be paid to this cohort. In this review, we summarize and analyze specific clinical manifestations for patients with coexisting COVID-19 and HMs. Furthermore, we briefly describe customized management strategies and interventions for this susceptible cohort. This review is intended to guide clinical practice.

应对恶性血液肿瘤在新型冠状病毒肺炎疫情中的挑战

概要:新型冠状病毒肺炎(COVID-19)是一种由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的新型传染病.SARS-CoV-2具有极强的传染性,因此在引发流行病后又使其迅速升级为全球大流行,至今仍在部分国家迅速传播.在COVID-19的感染者中,存在肿瘤等慢性病或伴有相关合并症的患者预后往往较差.同时,由于恶性血液肿瘤患者长期处于免疫抑制状态,往往感染风险更高且预后更差,所以十分值得我们关注.这篇综述归纳并分析了恶性血液肿瘤患者合并COVID-19后的临床表现.此外,归纳了疫情期间恶性肿瘤的管理策略和感染后的综合干预措施,旨在为临床提供指导.
关键词:新型冠状病毒肺炎(COVID-19);恶性血液肿瘤;免疫抑制;管理策略;治疗方案

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1]Abruzzese E, Luciano L, D'Agostino F, et al., 2020. SARS-CoV-2 (COVID-19) and chronic myeloid leukemia (CML):a case report and review of ABL kinase involvement in viral infection. Mediterr J Hematol Infect Dis, 12(1):e2020031.

[2]Advani R, Bartlett N, Gordon L, et al., 2020a. COVID-19 and aggressive lymphoma: frequently asked questions. https://www.hematology.org/covid-19/covid-19-and-aggressive-lymphoma [Accessed on Aug. 1, 2020].

[3]Advani R, Bartlett N, Gordon L, et al., 2020b. COVID-19 and Hodgkin lymphoma: frequently asked questions. https:// www.hematology.org/covid-19/covid-19-and-hodgkin-lymphoma [Accessed on Aug. 1, 2020].

[4]Ai T, Yang ZL, Hou HY, et al., 2020. Correlation of chest CT and RT-PCR testing for coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology, 296(2):E32-E40.

[5]Al Saleh AS, Sher T, Gertz MA, 2020. Multiple myeloma in the time of COVID-19. Acta Haematol, 143(5):410-416.

[6]Atzeni F, Boiardi L, Salli S, et al., 2013. Lung involvement and drug-induced lung disease in patients with rheumatoid arthritis. Expert Rev Clin Immunol, 9(7):649-657.

[7]Bachanova V, Bishop MR, Dahi P, et al., 2020. Chimeric antigen receptor T cell therapy during the COVID-19 pandemic. Biol Blood Marrow Transplant, 26(7):1239-1246.

[8]Balduzzi A, Brivio E, Rovelli A, et al., 2020. Lessons after the early management of the COVID-19 outbreak in a pediatric transplant and hemato-oncology center embedded within a COVID-19 dedicated hospital in Lombardia, Italy. Estote parati. Bone Marrow Transplant, 55(10):1905.

[9]Baumann T, Delgado J, Montserrat E, 2020. CLL and COVID-19 at the hospital clinic of Barcelona: an interim report. Leukemia, 34(7):1954-1956.

[10]Boulware DR, Pullen MF, Bangdiwala AS, et al., 2020. A randomized trial of hydroxychloroquine as postexposure prophylaxis for COVID-19. N Engl J Med, 383(6):517-525.

[11]Brissot E, Labopin M, Baron F, et al., 2020. Management of patients with acute leukemia during the COVID-19 outbreak: practical guidelines from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Bone Marrow Transplant, online.

[12]Burnett AK, Russell NH, Hills RK, et al., 2013. Optimization of chemotherapy for younger patients with acute myeloid leukemia: results of the medical research council AML15 trial. J Clin Oncol, 31(27):3360-3368.

[13]Busca A, 2012. Viral infections in patients with hematological malignancies. Leuk Suppl, 1(S2):S24-S25.

[14]Byrne CJ, Roberts JA, McWhinney B, et al., 2017. Variability in trough total and unbound teicoplanin concentrations and achievement of therapeutic drug monitoring targets in adult patients with hematological malignancy. Antimicrob Agents Chemother, 61(6):e02466-16.

[15]Chauhan AJ, Wiffen LJ, Brown TP, 2020. COVID-19: a collision of complement, coagulation and inflammatory pathways. J Thromb Haemost, 18(9):2110-2117.

[16]Chen Z, Xiong H, Li JX, et al., 2020. COVID-19 with post-chemotherapy agranulocytosis in childhood acute leukemia: a case report. Chin J Hematol, 41(4):341-343 (in Chinese).

[17]China National Health Commission, 2020. Chinese Clinical Guidance for COVID-19 pneumonia diagnosis and treatment (7th Edition). http://kjfy.meetingchina.org/msite/news/show/cn/3337.html?from=singlemessage&isappinstalled=0 [Accessed on Mar. 4, 2020].

[18]Cook G, Ashcroft AJ, Pratt G, et al., 2020. Real-world assessment of the clinical impact of symptomatic infection with severe acute respiratory syndrome coronavirus (COVID-19 disease) in patients with multiple myeloma receiving systemic anti-cancer therapy. Br J Haematol, 190(2):e83-e86.

[19]Cordonnier C, Alanio A, Cesaro S, et al., 2017. Pneumocystis jirovecii pneumonia: still a concern in patients with haematological malignancies and stem cell transplant recipients-authors’ response. J Antimicrob Chemother, 72(4):1266-1268.

[20]di Ciaccio P, McCaughan G, Trotman J, et al., 2020. Australian and New Zealand consensus statement on the management of lymphoma, chronic lymphocytic leukaemia and myeloma during the COVID-19 pandemic. Intern Med J, 50(6):667-679.

[21]DiNardo CD, Pratz K, Pullarkat V, et al., 2019. Venetoclax combined with decitabine or azacitidine in treatment-naive, elderly patients with acute myeloid leukemia. Blood, 133(1):7-17.

[22]Ector GICG, Huijskens EGW, Blijlevens NMA, et al., 2020. Prevalence of COVID-19 diagnosis in Dutch CML patients during the 2020 SARS-CoV2 pandemic. A prospective cohort study. Leukemia, 34(9):2533-2535.

[23]ESMO (European Society for Medical Oncology), 2020a. ESMO management and treatment adapted recommendations in the COVID-19 era: diffuse large B-cell lymphoma, mantle cell lymphoma and aggressive T-cell lymphomas. https://www.esmo.org/guidelines/cancer-patient-management-during-the-covid-19-pandemic/haematological-malignancies-dlbcl-mcl-and-aggressive-t-cell-lymphoma-in-the-second-phase-of-the-covid-19-pandemic-esmo-eha [Accessed on Aug. 1, 2020].

[24]ESMO (European Society for Medical Oncology), 2020b. ESMO management and treatment adapted recommendations in the COVID-19 era: hodgkin lymphoma. https:// www.esmo.org/guidelines/cancer-patient-management-during-the-covid-19-pandemic/haematological-malignancies-hodgkin-lymphoma-in-the-second-phase-of-the-covid-19-pandemic-esmo-eha [Accessed on Aug. 1, 2020].

[25]Farmer I, Okikiolu J, Steel M, et al., 2020. Acute promyelocytic leukaemia lying under the mask of COVID-19— a diagnostic and therapeutic conundrum. Br J Haematol, 190(4):e248-e250.

[26]Foà R, Bonifacio M, Chiaretti S, et al., 2020. Philadelphia-positive acute lymphoblastic leukaemia (ALL) in Italy during the COVID-19 pandemic: a Campus ALL study. Br J Haematol, 190(1):e3-e5.

[27]Fontana L, Strasfeld L, 2019. Respiratory virus infections of the stem cell transplant recipient and the hematologic malignancy patient. Infect Dis Clin North Am, 33(2):523-544.

[28]Freeman CL, Sehn LH, 2018. A tale of two antibodies: obinutuzumab versus rituximab. Br J Haematol, 182(1):29-45.

[29]Gavillet M, Klappert JC, Spertini O, et al., 2020. Acute leukemia in the time of COVID-19. Leuk Res, 92:106353.

[30]Gavriatopoulou M, Korompoki E, Fotiou D, et al., 2020. Organ-specific manifestations of COVID-19 infection. Clin Exp Med, 20(4):493-506.

[31]Gruber F, Mustjoki S, Porkka K, 2009. Impact of tyrosine kinase inhibitors on patient outcomes in Philadelphia chromosome-positive acute lymphoblastic leukaemia. Br J Haematol, 145(5):581-597.

[32]Gu JY, Han B, Wang J, 2020. COVID-19: gastrointestinal manifestations and potential fecal-oral transmission. Gastroenterology, 158(6):1518-1519.

[33]Guan WJ, Ni ZY, Hu Y, et al., 2020. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med, 382(18):1708-1720.

[34]Hamming I, Timens W, Bulthuis MLC, et al., 2004. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol, 203(2):631-637.

[35]Han QM, Lin QQ, Jin SH, et al., 2020. Coronavirus 2019-nCoV: a brief perspective from the front line. J Infect, 80(4):373-377.

[36]He WJ, Chen L, Chen L, et al., 2020. COVID-19 in persons with haematological cancers. Leukemia, 34(6):1637-1645.

[37]Jamilloux Y, Henry T, Belot A, et al., 2020. Should we stimulate or suppress immune responses in COVID-19? Cytokine and anti-cytokine interventions. Autoimmun Rev, 19(7):102567.

[38]Jin XH, Zheng KI, Pan KH, et al., 2020. COVID-19 in a patient with chronic lymphocytic leukaemia. Lancet Haematol, 7(4):E351-E352.

[39]Jones DL, Baluja MQ, Graham DW, et al., 2020. Shedding of SARS-CoV-2 in feces and urine and its potential role in person-to-person transmission and the environment-based spread of COVID-19. Sci Total Environ, 749:141364.

[40]June CH, Sadelain M, 2018. Chimeric antigen receptor therapy. N Engl J Med, 379(1):64-73.

[41]Koo HJ, Lim S, Choe J, et al., 2018. Radiographic and CT features of viral pneumonia. Radiographics, 38(3):719-739.

[42]Lagunas-Rangel FA, 2020. Neutrophil-to-lymphocyte ratio and lymphocyte-to-C-reactive protein ratio in patients with severe coronavirus disease 2019 (COVID-19):a meta-analysis. J Med Virol, 92(10):1733-1734.

[43]Li T, Yang Z, Jiang S, et al., 2018. Melatonin: does it have utility in the treatment of haematological neoplasms? Br J Pharmacol, 175(16):3251-3262.

[44]Li WM, Wang DY, Guo JM, et al., 2020. COVID-19 in persons with chronic myeloid leukaemia. Leukemia, 34(7):1799-1804.

[45]Liang T, Cai HL, Chen Y, et al., 2020. Handbook of COVID-19 Prevention and Treatment. https://gmcc.alibabadoctor.com/ prevention-manual [Accessed on Mar. 18, 2020].

[46]Liang WH, Guan WJ, Chen RC, et al., 2020. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol, 21(3):335-337.

[47]Ljungman P, Mikulska M, de la Camara R, et al., 2020. The challenge of COVID-19 and hematopoietic cell transplantation; EBMT recommendations for management of hematopoietic cell transplant recipients, their donors, and patients undergoing CAR T-cell therapy. Bone Marrow Transplant, 55:2071-2076.

[48]Malard F, Mohty M, 2020. Management of patients with multiple myeloma during the COVID-19 pandemic. Lancet Haematol, 7(6):E435-E437.

[49]Malard F, Genthon A, Brissot E, et al., 2020. COVID-19 outcomes in patients with hematologic disease. Bone Marrow Transplant, 55(11):2180-2184.

[50]Mao L, Jin HJ, Wang MD, et al., 2020. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol, 77(6):683-690.

[51]Mauro M, Druker B, Radich J, et al., 2020. COVID-19 and CML: frequently asked questions. https://www.hematology. org/covid-19/covid-19-and-cml [Accessed on Aug. 1, 2020].

[52]Mayer RJ, Davis RB, Schiffer CA, et al., 1994. Intensive postremission chemotherapy in adults with acute myeloid leukemia. N Engl J Med, 331(14):896-903.

[53]Mehta P, McAuley DF, Brown M, et al., 2020. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet, 395(10229):1033-1034.

[54]Molica M, Mazzone C, Cordone I, et al., 2020. SARS-CoV-2 infection anxieties and general population restrictions delay diagnosis and treatment of acute haematological malignancies. Br J Haematol, 190(1):e5-e8.

[55]NCCN (National Comprehensive Cancer Network), 2020. NCCN Guidelines®. https://www.nccn.org/professionals/ physician_gls/default.aspx [Accessed on July 1, 2020].

[56]O'Kelly B, McGettrick P, Angelov D, et al., 2020. Outcome of a patient with refractory Hodgkin lymphoma on pembrolizumab, infected with SARS-CoV-2. Br J Haematol, 190(1):e1-e3.

[57]Paneesha S, Pratt G, Parry H, et al., 2020. COVID-19 infection in therapy-naive patients with B-cell chronic lymphocytic leukemia. Leuk Res, 93:106366.

[58]Playe M, Siavellis J, Braun T, et al., 2020. FDG PET/CT in a patient with mantle cell lymphoma and COVID-19: typical findings. Clin Nucl Med, 45(7):e305-e306.

[59]Psaltopoulou T, Sergentanis TN, Pappa V, et al., 2020. The emerging role of convalescent plasma in the treatment of COVID-19. Hemasphere, 4(3):e409.

[60]Rajkumar MCSV, Mikhail J, Mateos MM, et al., 2020. COVID-19 and multiple myeloma: frequently asked questions. https:// www.hematology.org/covid-19/covid-19-and-multiple-myeloma [Accessed on Aug. 1, 2020].

[61]Raza A, Assal A, Ali AM, et al., 2020. Rewriting the rules for care of MDS and AML patients in the time of COVID-19. Leuk Res Rep, 13:100201.

[62]Scarfò L, Chatzikonstantinou T, Rigolin GM, et al., 2020. COVID-19 severity and mortality in patients with chronic lymphocytic leukemia: a joint study by ERIC, the European research initiative on CLL, and CLL campus. Leukemia, 34(9):2354-2363.

[63]Shadman JBM, Hallek M, Brown J, et al., 2020. COVID-19 and CLL: frequently asked questions. https://www. hematology.org/covid-19/covid-19-and-cll [Accessed on Aug. 1, 2020].

[64]Siegel RL, Miller KD, Jemal A, 2019. Cancer statistics, 2019. CA Cancer J Clin, 69(1):7-34.

[65]Sieni E, Pegoraro F, Casini T, et al., 2020. Favourable outcome of coronavirus disease 2019 in a 1-year-old girl with acute myeloid leukaemia and severe treatment-induced immunosuppression. Br J Haematol, 189(6):e222-e224.

[66]Subspecialty Group of Hematology and Oncology, Society of Pediatrics of Hubei, 2020. Standardized management guideline for pediatric wards of hematology and oncology during the epidemic of coronavirus disease 2019. Chin J Contemp Pediatr, 22(3):177-182 (in Chinese).

[67]Stock W, Patel A, O'Dwyer K, et al., 2020. COVID-19 and adult ALL: frequently asked questions. https://www. hematology.org/covid-19/covid-19-and-all [Accessed on Aug. 1, 2020].

[68]Tallman M, Rollig C, Zappasodi P, et al., 2020. COVID-19 and acute myeloid leukemia: frequently asked questions. https://www.hematology.org/covid-19/covid-19-and-acute-myeloid-leukemia [Accessed on Aug. 1, 2020].

[69]Terpos E, Ntanasis-Stathopoulos I, Elalamy I, et al., 2020a. Hematological findings and complications of COVID-19. Am J Hematol, 95(7):834-847.

[70]Terpos E, Engelhardt M, Cook G, et al., 2020b. Management of patients with multiple myeloma in the era of COVID-19 pandemic: a consensus paper from the European myeloma network (EMN). Leukemia, 34(8):2000-2011.

[71]Treon SP, Castillo JJ, Skarbnik AP, et al., 2020. The BTK inhibitor ibrutinib may protect against pulmonary injury in COVID-19-infected patients. Blood, 135(21):1912-1915.

[72]Wang DY, Guo JM, Yang ZZ, et al., 2020. The first report of the prevalence of COVID-19 in chronic myelogenous leukemia patients in the core epidemic area of China: multicentre, cross-sectional survey. medRxiv, reprint.

[73]Wang XH, Fang XX, Cai ZX, et al., 2020. Comorbid chronic diseases and acute organ injuries are strongly correlated with disease severity and mortality among COVID-19 patients: a systemic review and meta-analysis. Research, 2020:2402961.

[74]https://doi.org/10.34133/2020/2402961

[75]Wang YD, Zhang SP, Wei QZ, et al., 2020. COVID-19 complicated with DIC: 2 cases report and literatures review. Chin J Hematol, 41(3):245-247 (in Chinese).

[76]Wiersinga WJ, Rhodes A, Cheng AC, et al., 2020. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19):a review. JAMA, 324(8):782-793.

[77]World Health Organization, 2020. WHO coronavirus disease (COVID-19) dashboard. https://covid19.who.int [Accessed on Oct. 9, 2020].

[78]Wu YL, Lin H, Xie Q, et al., 2020. COVID-19 in a patient with pre-existing acute lymphoblastic leukaemia. Br J Haematol, 190(1):e13-e15.

[79]Xia JH, Tong JP, Liu MY, et al., 2020. Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS-CoV-2 infection. J Med Virol, 92(6):589-594.

[80]Yang KY, Sheng YH, Huang CL, et al., 2020. Clinical characteristics, outcomes, and risk factors for mortality in patients with cancer and COVID-19 in Hubei, China: a multicentre, retrospective, cohort study. Lancet Oncol, 21(7):904-913.

[81]Zanoni L, Mosconi C, Cervati V, et al., 2020. [18F]-FDG PET/CT for suspected lymphoma relapse in a patient with concomitant pneumococcal pneumonia during COVID-19 outbreak: unexpected SARS-CoV-2 co-infection despite double RT-PCR negativity. Eur J Nucl Med Mol Imaging, 47(8):2038-2039.

[82]Zhang XH, Song KD, Tong F, et al., 2020. First case of COVID-19 in a patient with multiple myeloma successfully treated with tocilizumab. Blood Adv, 4(7):1307-1310.

[83]Zhao Y, Zhao WH, Wang AB, et al., 2020. First case of coronavirus disease 2019 in childhood leukemia in China. Pediatr Infect Dis J, 39(7):e142-e145.

[84]Zhou F, Yu T, Du RH, et al., 2020. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet, 395(10229):1054-1062.

[85]Zhou P, Yang XL, Wang XG, et al., 2020. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature, 579(7798):270-273.

[86]Zhu HH, Huang XJ, 2014. Oral arsenic and retinoic acid for non-high-risk acute promyelocytic leukemia. N Engl J Med, 371(23):2239-2241.

Open peer comments: Debate/Discuss/Question/Opinion

<1>

Please provide your name, email address and a comment





Journal of Zhejiang University-SCIENCE, 38 Zheda Road, Hangzhou 310027, China
Tel: +86-571-87952783; E-mail: cjzhang@zju.edu.cn
Copyright © 2000 - Journal of Zhejiang University-SCIENCE