Neutropenia in adult acute myeloid leukemia patients represents a powerful risk factor for COVID-19 related mortality

Abstract

Patients with hematological malignancies are at risk for poor outcomes when diagnosed with coronavirus disease 2019 (COVID-19). It remains unclear whether cytopenias and specific leukemia subtypes play a role in the clinical course of COVID-19 infection. Here, we report outcomes and their clinical/laboratory predictors for 65 patients with acute and chronic leukemias diagnosed with COVID-19 between 8 March 2020 and 19 May 2020 at Memorial Sloan Kettering Cancer Center in New York City. Most patients had CLL (38%) or AML (26%). A total of 14 (22%) patients required high flow nasal cannula or were intubated for mechanical ventilation and 11 patients (17%) died. A diagnosis of AML (OR 4.7, p=.028), active treatment within the last 3 months (OR 5.22, p=.047), neutropenia within seven days prior and up to 28 days after SARS-CoV-2 diagnosis (11.75, p=.001) and ≥3 comorbidities (OR 6.55, p=.019) were associated with increased odds of death.

Keywords:

• COVID-19
• SARS-CoV-2
• leukemia

Disclosure statement

Maximilian Stahl consulted for Boston Consulting group (BCG).

Anthony R. Mato has served as a consultant and received research funding from Curio Science, TG Therapeutics, Celgene, Janssen; AbbVie, Adaptive, Loxo, Nurix, Genmab, Genentech, Pfizer, Octopharma, Pharmacyclics, AstraZeneca, Sunesis, DTRM, Gilead, and Johnson & Johnson. He served as DSMB member at TG Therapeutics.

Lindsey E, Roeker served as a consultant for AbbVie, AstraZeneca, Jansen, LOXO, Pharmacyclics, Pfizer, TG Therapeutics, and Vaniam group, holds minority ownership interest in Abbott Laboratories, and has received research funding (paid to the institution) from Pfizer and Aptose Biosciences outside of the submitted work.

Mark B. Geyer received research funding from Actinium Pharmaceuticals, Inc.

Additional information

Funding

Maximilian Stahl received funding from the MSKCC Clinical Scholars T32 Program under award number [T32 CA009512-31] and support from an ASCO/Conquer Cancer Foundation Young Investigator Award. Varun Narendra received funding from the MSKCC Clinical Scholars T32 Program under award number [T32-CA009512]. Justin Jee received funding from the MSKCC T32 Program under award number [T32 CA009207]. Research reported in this publication was supported by the Cancer Center Support Grant/Core Grant to Memorial Sloan Kettering Cancer Center [P30 CA008748]. Aaron Goldberg received funding from an American Society of Hematology (ASH) Fellow Scholar Award in Clinical Research.