Frequency, clinical characteristics and outcome of adults with acute lymphoblastic leukemia and COVID 19 infection in the first vs. second pandemic wave in Spain

Ribera, Josep-Maria; Morgades, Mireia; Coll, Rosa; Barba, Pere; López-Lorenzo, Jose-Luis; Montesinos, Pau; Foncillas, María-Angeles; Cabrero, Mónica; Gómez-Centurión, Ignacio; Morales, María-Dolores; Varela, María-Rosario; Herrera, Pilar; García-Cadenas, Irene; Calbacho, María; Torrent, Anna; Maluquer, Clara; Calabuig, Marisa; Garcia-Guiñon, Antoni; Bautista, Guiomar; Llorente, Laura; Gil, Cristina; Artola, María-Teresa; González-Campos, José; Fernández-Moreno, Ainhoa; Bárez, Abelardo; Giménez-Pérez, Teresa; Bergua, Juan; Sánchez-Sánchez, María-José; Mateos, María-Carmen; Piñana, José-Luis

BACKGROUND AND OBJECTIVE: . SARS-CoV-2 infection has bimodal distribution in Europe with a 1st wave in March-June 2020 and a 2nd in September 2020-February 2021. We compared the frequency, clinical characteristics and outcomes of adults with acute lymphoblastic leukemia (ALL) and infection in the 1st vs. 2nd pandemic waves in Spain. PATIENTS AND METHODS: . In this prospective study the characteristics of ALL and COVID-19 infection, comorbidities, treatment and outcome in the two periods were compared. The study ended when vaccination against SARS-CoV-2 was implemented in Spain. RESULTS: . Twenty-eight patients were collected in the 1st wave and 24 in the 2nd. The median age was 46.5 years (range 20-83). Patients from the 1st wave had a trend to more severe ALL (higher frequency of patients under induction or submitted to transplantation or under immunosuppressive therapy). No significant differences were observed in need for oxygen support, intensive care unit (ICU) requirement, days in ICU and time to COVID-19 infection recovery. Seventeen patients (33%) died, with death attributed to COVID infection in 15 (29%), without significant differences in the 100-day overall survival (OS) probabilities in the two waves (68%±17% vs. 56%±30%). The only prognostic factor for OS identified by was the presence of comorbidities at COVID-19 infection (HR: 5.358 [95% CI: 1.875- 15.313]). CONCLUSION: . The frequency and mortality of COVID-19 infection were high in adults with ALL, without changes over time, providing evidence in favor of vaccination priority for these patients.