Patients with hematologic malignancies and coronavirus disease 2019 (COVID-19) infection who were undergoing systemic anticancer therapy did not have an increased risk of death relative to patients not receiving treatment, according to results of a study presented by Abi Vijenthira, MD, of the Princess Margaret Cancer Centre, in Toronto, Ontario, Canada, at the virtual 62nd American Society of Hematology (ASH) Annual Meeting and Exposition.
“Understanding the risks of COVID-19 for [hematology-oncology] patients remains an important unanswered question for hematologists,” said Dr Vijenthira.
The investigators performed a systematic literature review and meta-analysis to estimate the risk for mortality related to COVID-19 in pediatric and adult patients with hematologic malignancy and to determine the effects of age, race, and recent systemic anticancer treatment on patient death. The primary outcome was the risk for death in all patients.
The literature search yielded 34 adult and 5 pediatric studies, with a total of 3377 patients (77% of patients were hospitalized). The risk for death among adult patients (n=3240) was 34% (95% CI, 28-39); however, 14 of 34 studies were in hospitalized patients only. The risk for death among pediatric patients (n=102) was 4% (95% CI, 1-9).
According to study results recently published in Blood, patients older than 60 years were at significantly greater risk for death compared with patients younger than 60 years (risk ratio [RR], 1.82; 95% CI, 1.45-2.27; P <.00001).2 The risk for death was not greater for patients who recently received systemic anticancer therapy relative to those with no recent treatment (RR, 1.17; 95% CI, 0.83-1.64).2 Non-White patients had a significantly greater risk for death compared with White patients (RR, 2.2; 95% CI, 1.3-3.8; P =.003).
Limitations of the study included the rapidly growing number of publications on COVID-19 and that many of the studies only included hospitalized patients. The authors also noted significant heterogeneity of data and differing definitions among the studies. Another limitation of note was that only studies up to the week of August 17, 2020, were included in the analysis.
“It will be interesting to know if the rates of death in patients with [hematologic] malignancy have similarly improved with time,” Dr Vijenthira noted. “Mortality related to COVID-19 in patients with hematologic malignancies appears to be high but this estimate may be biased [due to the large] number of hospitalized patients in published studies.”
Disclosure: Some authors have declared affiliations with or received funding from the pharmaceutical industry. Please refer to the original study for a full list of disclosures.
Read more of Hematology Advisor’s coverage of the ASH 2020 meeting by visiting the conference page.
- Vijenthira A, Gong I, Fox TA, et al. Outcomes of adult and pediatric patients with hematologic malignancies and COVID-19: a systematic review and meta-analysis of 1847 patients. Presented at: American Society of Hematology (ASH) 62nd Annual Meeting and Exposition; December 5-8, 2020. Abstract 745.
- Vijenthira A, Gong IY, Fox TA, et al. Outcomes of patients with hematologic malignancies and COVID-19: a systematic review and meta-analysis of 3377 patients. Blood. Published online October 28, 2020. doi:10.1182/blood.2020008824
This article originally appeared on Hematology Advisor