EHA 2021 | Prolonged COVID-19 in lymphoma patients treated with immunotherapy
Caroline Besson, MD, PhD, Versailles Hospital Center, Paris, France and University of Paris-Saclay, Paris, France, discusses the high incidence of patients with B-cell non-Hodgkin lymphoma being hospitalised for prolonged COVID-19. A study conducted across 16 French hospitals investigated the risk factors and long-term outcomes of persistent COVID-19 in adult patients with lymphoma who were admitted to hospital for COVID-19 in March and April 2020. 32 out of 111 patients had persistent COVID-19 (defined as severe symptoms requiring hospitalisation for more than 30 days). No patient with T-cell lymphoma or classical Hodgkin’s disease had persistent COVID-19. The study reported a 6-month overall survival of 69%. Three factors were associated with decreased overall survival and a longer hospital stay: patients being over 70 years old, having relapsed or refractory lymphoma, or having received an anti-CD20 monoclonal antibody therapy within 12 months prior to hospital admission for COVID-19. Prof. Besson discusses the clinical implications for these findings. This interview took place at the virtual European Hematology Association (EHA) Congress 2021.
Transcript (edited for clarity)
We built a clinical epidemiological study in France during the first wave of the pandemic to study the outcomes and the characteristics of patients with procedural formal diagnosis and COVID-19 infection. First, we described the one-month evolution of these patients, and we brought that patient, patients aged above 70, those with refractory disease, have a worse outcome. Then, we increased our follow-up to more hospitals, more patients, and to a longer period of time to six months...
We built a clinical epidemiological study in France during the first wave of the pandemic to study the outcomes and the characteristics of patients with procedural formal diagnosis and COVID-19 infection. First, we described the one-month evolution of these patients, and we brought that patient, patients aged above 70, those with refractory disease, have a worse outcome. Then, we increased our follow-up to more hospitals, more patients, and to a longer period of time to six months. Then, we showed that again, there is an impact of age, refractory relapsed status of their lymphoma, co-morbidities, but also negative impact of recent B-cell depleting therapy. On most lengths of in-hospital stay, there’s also risk of mortality. So, this is the main message of this presentation.
This is important because when there is a big other epidemic, new wave of infections, it could be discouraged to delay the introduction of B-cell depleting therapy in patients with low-grade lymphomas, for example, how to stop for a while maintenance therapy with these treatments since they are associated with worse evolution of the COVID-19 disease. So, this is important.
It is also important because these patients may not have a good answer to vaccination. And we need to do further studies to analyze the vaccination in patients receiving B-cell depleting therapy. So, this happens new questions about the management of B-cell depleting therapy in patients with lymphoma when there is an epidemic wave of the SARS COV-2.
I think it is important also to mention that B-cell depleting therapy are an important treatment in patients with B-cell lymphoma. Of course, the goal is not to say to withdraw this treatment, which has shown its major impact of the evolution of lymphoma. So, when there is a clinical need for B-cell depleting therapy, this treatment should be pursued of course. But when it is possible to delay it for a while, now for example to allow vaccination, or to withdraw it during maintenance in patients with complete remission, this could be discussed. But, of course, when it is necessary for induction of lymphoma, for example, in no case this treatment should be suspended.
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Disclosures
Caroline Besson, MD, PhD, has received research funding from Rosche.
