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Prolonged in‐hospital stay and higher mortality after Covid‐19 among patients with <scp>non‐Hodgkin</scp> lymphoma treated with B‐cell depleting immunotherapy
- Source :
- 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⟩
- Publication Year :
- 2021
- Publisher :
- Wiley, 2021.
-
Abstract
- 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.
- Subjects :
- [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
Subjects
Details
- ISSN :
- 10968652 and 03618609
- Volume :
- 96
- Database :
- OpenAIRE
- Journal :
- American Journal of Hematology
- Accession number :
- edsair.doi.dedup.....e7c93552a83f08f61d53fc23e10bf133