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Covid-19 in patients with chronic lymphocytic leukemia: clinical outcome and B- and T-cell immunity during 13 months in consecutive patients
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2022 (English)In: Leukemia, ISSN 0887-6924, E-ISSN 1476-5551, Vol. 36, no 2, p. 476-481Article in journal (Refereed) Published
Abstract [en]

We studied clinical and immunological outcome of Covid-19 in consecutive CLL patients from a well-defined area during month 1–13 of the pandemic. Sixty patients (median age 71 y, range 43–97) were identified. Median CIRS was eight (4–20). Patients had indolent CLL (n = 38), had completed (n = 12) or ongoing therapy (n = 10). Forty-six patients (77%) were hospitalized due to severe Covid-19 and 11 were admitted to ICU. Severe Covid-19 was equally distributed across subgroups irrespective of age, gender, BMI, CLL status except CIRS (p < 0.05). Fourteen patients (23%) died; age ≥75 y was the only significant risk factor (p < 0.05, multivariate analysis with limited power). Comparing month 1–6 vs 7–13 of the pandemic, deaths were numerically reduced from 32% to 18%, ICU admission from 37% to 15% whereas hospitalizations remained frequent (86% vs 71%). Seroconversion occurred in 33/40 patients (82%) and anti-SARS-CoV-2 antibodies were detectable at six and 12 months in 17/22 and 8/11 patients, respectively. Most (13/17) had neutralizing antibodies and 19/28 had antibodies in saliva. SARS-CoV-2-specific T-cells (ELISpot) were detected in 14/17 patients. Covid-19 continued to result in high admission even among consecutive and young early- stage CLL patients. A robust and durable B and/or T cell immunity was observed in most convalescents.

Place, publisher, year, edition, pages
Springer Nature , 2022. Vol. 36, no 2, p. 476-481
Keywords [en]
anticoagulant agent, antineoplastic monoclonal antibody, bendamustine, Bruton tyrosine kinase inhibitor, corticosteroid, gamma interferon, hydroxychloroquine, hypertensive agent, immunoglobulin, immunoglobulin G antibody, neutralizing antibody, remdesivir, rituximab, SARS-CoV-2 antibody, SARS-CoV-2 convalescent plasma, tocilizumab, venetoclax, virus antibody, adult, aged, antibody response, Article, body mass, cellular immunity, chronic lymphatic leukemia, controlled study, coronavirus disease 2019, Cumulative Illness Rating Scale, enzyme linked immunospot assay, female, hospitalization, human, humoral immunity, intensive care, major clinical study, male, mortality rate, seroconversion, Sweden, B lymphocyte, blood, complication, follow up, immunology, isolation and purification, middle aged, multimodality cancer therapy, prognosis, T lymphocyte, very elderly, virology, Aged, 80 and over, Antibodies, Neutralizing, Antibodies, Viral, B-Lymphocytes, Combined Modality Therapy, COVID-19, Follow-Up Studies, Humans, Leukemia, Lymphocytic, Chronic, B-Cell, SARS-CoV-2, T-Lymphocytes
National Category
Infectious Medicine Immunology in the medical area
Identifiers
URN: urn:nbn:se:kth:diva-311786DOI: 10.1038/s41375-021-01424-wISI: 000700558800002PubMedID: 34564699Scopus ID: 2-s2.0-85115684185OAI: oai:DiVA.org:kth-311786DiVA, id: diva2:1655923
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QC 20220504

Available from: 2022-05-04 Created: 2022-05-04 Last updated: 2022-06-25Bibliographically approved

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Hober, SophiaMravinacová, SáraNilsson, PeterPin, Elisa

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