Prolonged in‐hospital stay and higher mortality after Covid‐19 among patients with non‐Hodgkin lymphoma treated with B‐cell depleting immunotherapy

Autor: Roberta Di Blasi, Laure Philippe, Thomas Hueso, Catherine Thieblemont, Karine Lacombe, Bénédicte Deau Fischer, Serge Bologna, Caroline Besson, Guillemette Fouquet, Sylvain Choquet, Milena Kohn, Rémy Duléry, Carole Soussain, Bernard Drenou, Pierre Feugier, Etienne Daguindau, Marc Delord, Nicolas Noel, Adrien Chauchet, Sylvain Lamure, Sandra Malak, Cédric Rossi, Bertrand Joly, Guillaume Cartron, Yassine Taoufik
Přispěvatelé: Service d'hématologie clinique et de thérapie cellulaire [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Institut de Génétique Moléculaire de Montpellier (IGMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Département d’Hématologie Clinique [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier de Versailles André Mignot (CHV), Service d'hématologie-oncologie adultes, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP), Service d'hématologie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Institut Gustave Roussy (IGR), Service d'Hématologie Clinique (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Groupe hospitalier de la région de Mulhouse Sud-Alsace (GHRMSA), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Curie [Saint-Cloud], Service d'Hématologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Service d'Hématologie clinique [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre d'Oncologie de Gentilly, Centre Hospitalier Sud Francilien, CH Evry-Corbeil, Service d'Hématologie [CH Annecy], CH Annecy, Hôpital Bicêtre, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Roche, Takeda Pharmaceutical Company, TPC, We thank all the clinicians and patients in the participating centers for their contributions to this multicenter study. We are grateful to the Centre Hospitalier de Versailles, in particular Philippe Rousselot and Laure Morisset for promoting the research and for supporting the editing. We thank France Lymphome Espoir for reviewing the study material, LYSA for discussions on the design of this study, and Sophie Rigaudeau and C?cile Laur?ana for their contribution to the collection of the cases., Rémy Duléry reports personal fees from Takeda, Novartis, and Biotest and non‐financial support from Gilead outside the submitted work. Roberta Di Blasi reports personal fees from Gilead and Novartis outside the submitted work. Serge Bologna reports personal fees from Janssen and Roche outside the submitted work. Guillaume Cartron reports personal fees from Roche, Celgene, Sanofi, Gilead, Janssen, and Abbvie outside the submitted work. Karine Lacombe reports personal fees and non‐financial support from Gilead, MSD, Abbvie, ViiV Healthcare, and Janssen outside the submitted work. Caroline Besson reports research funding from Roche and non‐financial support from Takeda and Roche outside the submitted work., HAL UVSQ, Équipe, Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Groupe hospitalier de la région de Mulhouse et Sud-Alsace, Département d'Oncologie Médicale [Centre René-Huguenin, Saint-Cloud], Hôpital René HUGUENIN (Saint-Cloud), Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois], Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)
Rok vydání: 2021
Předmět:
[SDV.MHEP.HEM] Life Sciences [q-bio]/Human health and pathology/Hematology
Male
[SDV]Life Sciences [q-bio]
MESH: COVID-19 / complications
Comorbidity
MESH: Lymphoma
Non-Hodgkin / complications
0302 clinical medicine
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
Risk Factors
hemic and lymphatic diseases
Antineoplastic Combined Chemotherapy Protocols
MESH: Age Factors
Young adult
Research Articles
[SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases
Aged
80 and over
[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases
B-Lymphocytes
education.field_of_study
Lymphoma
Non-Hodgkin
MESH: SARS-CoV-2
Hazard ratio
Age Factors
[SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology
Hematology
Middle Aged
Combined Modality Therapy
MESH: Antigens
CD20 / immunology
3. Good health
030220 oncology & carcinogenesis
[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases
Female
Rituximab
B-cell depleting immunotherapy
Immunotherapy
[SDV.IMM.IMM] Life Sciences [q-bio]/Immunology/Immunotherapy
Research Article
medicine.drug
Adult
medicine.medical_specialty
Population
lymphoma
[SDV.CAN]Life Sciences [q-bio]/Cancer
anti-CD20 therapy
Young Adult
MESH: Rituximab / administration & dosage
03 medical and health sciences
[SDV.CAN] Life Sciences [q-bio]/Cancer
MESH: COVID-19 / mortality
Internal medicine
medicine
Humans
education
MESH: B-Lymphocytes / drug effects
Survival analysis
Aged
Proportional Hazards Models
Retrospective Studies
MESH: Aged
80 and over
SARS-CoV-2
Proportional hazards model
business.industry
COVID-19
Retrospective cohort study
[SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy
MESH: Combined Modality Therapy
Length of Stay
vaccination
Antigens
CD20
medicine.disease
Survival Analysis
Lymphoma
[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie
Drug Resistance
Neoplasm
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
business
030215 immunology
Zdroj: American Journal of Hematology
American Journal of Hematology, Wiley, 2021, 96 (8), pp.934-944. ⟨10.1002/ajh.26209⟩
American Journal of Hematology, 2021, 96 (8), pp.934-944. ⟨10.1002/ajh.26209⟩
ISSN: 1096-8652
0361-8609
DOI: 10.1002/ajh.26209
Popis: International audience; Prolonged Covid-19 is an emerging issue for patients with lymphoma or immune deficiency. We aimed to examine prolonged length of in-hospital stay (LOS) due to Covid-19 among patients with lymphoma and assess its determinants and outcomes. Adult patients with lymphoma admitted for Covid-19 to 16 French hospitals in March and April, 2020 were included. Length of in-hospital stay was analyzed as a competitor vs death. The study included 111 patients. The median age was 65 years (range, 19–92). Ninety-four patients (85%) had B-cell non-Hodgkin lymphoma. Within the 12 months prior to hospitalization for Covid-19, 79 patients (71%) were treated for their lymphoma. Among them, 63 (57%) received an anti-CD20 therapy. Fourteen patients (12%) had relapsed/refractory disease. The median LOS was 14 days (range, 1–235). After a median follow-up of 191 days (3–260), the 6-month overall survival was 69%. In multivariable analyses, recent administration of anti-CD20 therapy was associated with prolonged LOS (subdistribution hazard ratio 2.26, 95% confidence interval 1.42–3.6, p < 0.001) and higher risk of death (hazard ratio 2.17, 95% confidence interval 1.04–4.52, p = 0.039). An age ≥ 70 years and relapsed/refractory lymphoma were also associated with prolonged LOS and decreased overall survival. In conclusion, an age ≥ 70 years, a relapsed/refractory lymphoma and recent administration of anti-CD20 therapy are risk factors for prolonged LOS and death for lymphoma patients hospitalized for Covid-19. These findings may contribute to guide the management of lymphoma during the pandemic, support evaluating specific therapeutic approaches, and raise questions on the efficacy and timing of vaccination of this particular population.
Databáze: OpenAIRE
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