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Review

COVID-19 and Adult Acute Leukemia: Our Knowledge in Progress

1
Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
2
Mildred Scheel Cancer Career Center, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
3
The I. Department of Internal Medicine, Division of Infectious Diseases, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editor: Mingyi Chen
Cancers 2022, 14(15), 3711; https://doi.org/10.3390/cancers14153711
Received: 20 June 2022 / Revised: 25 July 2022 / Accepted: 28 July 2022 / Published: 29 July 2022
(This article belongs to the Special Issue COVID-19 Infection and Hematological Malignancies)
We herein report a review of the current literature on adult patients with acute leukemia (AL) infected with SARS-CoV-2. SARS-CoV-2-associated mortality ranges from 20–52% in adult patients with AL, and patients with acute myeloid leukemia have a particularly high COVID-19-related mortality. Of note, most of the available data relate to the pre-vaccination era and to variants before Omicron. Based on expert opinions, the current recommendations suggest delaying systemic AL treatment in SARS-CoV-2-positive patients until SARS-CoV-2 negativity, if immediate AL treatment is not required. It is recommended to offer vaccination to all AL patients, and seronegative patients should additionally receive prophylactic administration of anti-SARS-CoV-2 monoclonal antibodies. Patients with AL infected with SARS-CoV-2 should be treated early with antiviral therapy to prevent disease progression and to enable the rapid elimination of the virus.
The majority of publications regarding SARS-CoV-2 infections in adult patients with acute leukemia (AL) refer to hematological patients in general and are not focused on acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL). We herein report a review of the current literature on adult AL patients infected with SARS-CoV-2. Overall, SARS-CoV-2-associated mortality ranges from 20–52% in patients with adult AL. AML patients have a particularly high COVID-19-related mortality. Of note, most of the available data relate to the pre-vaccination era and to variants before Omicron. The impact of COVID-19 infections on AL treatment is rarely reported. Based on the few studies available, treatment delay does not appear to be associated with an increased risk of relapse, whereas therapy discontinuation was associated with worse outcomes in AML patients. Therefore, the current recommendations suggest delaying systemic AL treatment in SARS-CoV-2-positive patients until SARS-CoV-2 negativity, if immediate AL treatment is not required. It is recommended to offer vaccination to all AL patients; the reported antibody responses are around 80–96%. Seronegative patients should additionally receive prophylactic administration of anti-SARS-CoV-2 monoclonal antibodies. Patients with AL infected with SARS-CoV-2 should be treated early with antiviral therapy to prevent disease progression and enable the rapid elimination of the virus. View Full-Text
Keywords: adult acute leukemia; COVID-19; SARS-CoV-2 adult acute leukemia; COVID-19; SARS-CoV-2
MDPI and ACS Style

Modemann, F.; Ghandili, S.; Schmiedel, S.; Weisel, K.; Bokemeyer, C.; Fiedler, W. COVID-19 and Adult Acute Leukemia: Our Knowledge in Progress. Cancers 2022, 14, 3711. https://doi.org/10.3390/cancers14153711

AMA Style

Modemann F, Ghandili S, Schmiedel S, Weisel K, Bokemeyer C, Fiedler W. COVID-19 and Adult Acute Leukemia: Our Knowledge in Progress. Cancers. 2022; 14(15):3711. https://doi.org/10.3390/cancers14153711

Chicago/Turabian Style

Modemann, Franziska, Susanne Ghandili, Stefan Schmiedel, Katja Weisel, Carsten Bokemeyer, and Walter Fiedler. 2022. "COVID-19 and Adult Acute Leukemia: Our Knowledge in Progress" Cancers 14, no. 15: 3711. https://doi.org/10.3390/cancers14153711

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