COVID-19 in patients with classic and variant hairy cell leukemia.

Autor:	Kreitman RJ; Laboratory of Molecular Biology, National Cancer Institute, National Institutes of Health, Bethesda, MD., Yu T; Office of Research Nursing, National Cancer Institute, National Institutes of Health, Bethesda, MD., James L; Laboratory of Molecular Biology, National Cancer Institute, National Institutes of Health, Bethesda, MD., Feurtado J; Office of Research Nursing, National Cancer Institute, National Institutes of Health, Bethesda, MD., Eager H; Office of Research Nursing, National Cancer Institute, National Institutes of Health, Bethesda, MD., Ortiz OS; Office of Research Nursing, National Cancer Institute, National Institutes of Health, Bethesda, MD., Gould M; Laboratory of Molecular Biology, National Cancer Institute, National Institutes of Health, Bethesda, MD., Mauter J; Laboratory of Molecular Biology, National Cancer Institute, National Institutes of Health, Bethesda, MD., Zhou H; Laboratory of Molecular Biology, National Cancer Institute, National Institutes of Health, Bethesda, MD., Burbelo PD; National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD., Cohen JI; Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD., Wang HW; Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD., Yuan CM; Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD., Arons E; Laboratory of Molecular Biology, National Cancer Institute, National Institutes of Health, Bethesda, MD.
Jazyk:	angličtina
Zdroj:	Blood advances [Blood Adv] 2023 Dec 12; Vol. 7 (23), pp. 7161-7168.
DOI:	10.1182/bloodadvances.2023011147
Abstrakt:	Hairy cell leukemia (HCL), similar to its variant HCLv, is a B-cell malignancy associated with decreased humoral immunity. We prospectively monitored the largest cohort of patients with HCL/HCLv to date (n = 503) for COVID-19 by symptoms, antibody, and polymerase chain reaction (PCR) and/or antigen positivity. Fifty percent (253 of 503) of the patients with HCL/HCLv (238 HCL and 15 HCLv) had evidence of COVID-19, with 210 (83%) testing positive by PCR or rapid-antigen test. Of the 43 patients without positive tests, all had nucleocapsid antibodies indicating COVID-19 exposure, 7 recalled no symptoms, and 36 had mild symptoms. Of the 210 who tested positive, 23, 46, 129, and 12 cases occurred in 2020, 2021, 2022, and 2023, respectively. Among them, 175 began treatment for HCL/HCLv 0.4 to 429 (median, 66) months before, and 132 had their last dose of anti-CD20 monoclonal antibody 0.2 to 229 (median, 63) months before. Two patients died, including a young woman who began rituximab 2 months after first-line cladribine before vaccine availability. Nearly all patients with HCL/HCLv recovered uneventfully from COVID-19 including those without vaccination or those with significant immunosuppression and recent treatment. However, decreased normal B cells from HCL or treatment was associated with lower spike antibody levels as a response to COVID-19 (P = .0094) and longer recovery time (P = .0036). Thus, in a large cohort of patients with HCL/HCLv and in the first to determine relationships between COVID-19 outcome and immune markers, mortality was relatively low (∼1%), sequelae were uncommon, and recovery from COVID-19 was longer if normal B cells were low after recent treatment. The trials are registered at www.clinicaltrials.gov as #NCT01087333 and #NCT04362865. (Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu