COVID-19 in patients with chronic myeloid leukemia: management challenges and outcomes

Abstract

Introduction. A growing number of studies indicates the increased susceptibility of patients with hematologic malignancies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection as compared to the apparently healthy population. The objective of our study was to identify and evaluate the contemporary epidemiological and diagnosis patterns of chronic myeloid leukemia (CML) in the context of coronavirus disease 2019 (COVID-19) pandemic, to optimize the management of this hematologic malignancy. Material and methods. This analytical, descriptive and prospective study included 15 patients with CML and COVID-19, who were treated and followed up in the Institute of Oncology Chisinau, Republic of Moldova, between 2005–2021. SARS-CoV-2 infection was diagnosed in these patients between April 2020–September 2021. Results. These 15 cases represented 10.6% out of 142 patients diagnosed with CML and followed up under the treatment with tyrosine kinase inhibitors. There were 9 (60.0%) males and 6 (40.0%) females, with the male/female ratio 1.5/1. The patients’ age at diagnosis of COVID-19 ranged between 38-74 years (average age 54.2 years). According to the World Health Organization classification of COVID-19 severity, mild forms were registered in 4 (26.7%) cases, moderate in 6 (40.0%) and severe in 5 (33.3%) cases. Eight (53.3%) patients were hospitalized for treatment of COVID-19: 5 patients with severe forms and 3 patients with moderate forms. Viral pneumonia was diagnosed in 6 patients: 5 with severe and one with moderate form of COVID-19. Non-infectious comorbidities were registered in 4 of 5 patients with severe COVID-19 forms. Conclusions. COVID-19 commonly affects CML patients of male gender and older than the average age of patients with CML. Patients without hematologic response presented an unfavorable evolution of both diseases, CML and COVID-19.