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3040 Risks for Hospitalization and Death Among Patients with Blood Disorders from the ASH RC COVID-19 Registry for Hematology

Program: Oral and Poster Abstracts
Session: 905. Outcomes Research—Lymphoid Malignancies: Poster II
Hematology Disease Topics & Pathways:
Clinically Relevant, Clinical Practice (e.g. Guidelines, Health Outcomes and Services, and Survivorship, Value; etc.)
Sunday, December 12, 2021, 6:00 PM-8:00 PM

Lisa K. Hicks, MD, MSc1, Robert A. Redd, MS2*, Kenneth C. Anderson, MD3, Pinkal Desai, MD, MPH4, Brendan Dolan5*, Aaron D Goldberg, MD, PhD6, Varun Narendra, MD, PhD7*, Donna S. Neuberg, ScD8, Vivek Radhakrishnan9*, Laurie H. Sehn, MD10, Mikkael A. Sekeres, MD11, Maximilian Stahl, MD12, Martin S. Tallman, MD13, John Colton Thompson14*, Emily Tucker, MS15* and William A. Wood, MD, MPH16

1Division of Hematology/Oncology, St. Michael's Hospital, Toronto, ON, Canada
2Department of Data Science, Dana-Farber Cancer Institute, Boston, MA
3Jerome Lipper Multiple Myeloma Center, LeBow Institute for Myeloma Therapeutics, Dana-farber/Boston Children's Cancer and Blood Disorders Ctr, Boston, MA
4Division of Hematology and Oncology, Weill Cornell Medical College, New York, NY
5American Society for Hematology, Washington, DC
6Memorial Sloan Kettering Cancer Center, New York, NY
7Memorial Sloan Kettering Cancer Center, New York
8Data Science, Dana-Farber Cancer Institute, Boston, MA
9Tata Medical Center, Kolkata, India
10Centre for Lymphoid Cancer, British Columbia Cancer Agency, Vancouver, BC, Canada
11Division of Hematology, University of Miami, Sylvester Comprehensive Cancer Center, Miami, FL
12Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
13Memorial Sloan-Kettering Cancer Center, New York, NY
14American Society of Hematology, Washington, DC
15ASH Research Collaborative, Washington, DC
16Division of Hematology, Department of Medicine, University of North Carolina, Chapel Hill, NC

INTRODUCTION: Patients (pts) with blood disorders are at particular risk for severe infection and death from COVID-19. Factors that contribute to this risk, including cancer treatment, have not been clearly delineated. The ASH RC COVID-19 Registry for Hematology is a public-facing, volunteer registry reporting outcomes of COVID-19 infection in pts with underlying blood disorders. We report a multivariable analysis of the impact of cancer treatment and other key variables on COVID-19 mortality and hospitalization among pts with blood cancer.

METHODS: Data were collected between April 1, 2020, and July 2, 2021. All analyses were performed using R version 4.0.2. Multivariable logistic regression explored associations between mortality and seven patient/disease factors previously reported as important to COVID-19 outcome. Independent variables included: age (>60); sex; presence of a major comorbidity (defined as any of heart disease, hypertension, pulmonary disease and/or diabetes); type of hematologic malignancy; estimated prognosis of < 6 months prior to COVID-19; deferral of ICU care; and administration of cancer treatment in the previous year (excluding single agent hydroxyurea). A secondary multivariable logistic regression explored associations between the same variables and hospitalization with COVID-19.

RESULTS: We included all pts in the registry with a malignant diagnosis except for 3 patients excluded based on a data sharing agreement (N=1029). Median age category was 50-59y (range <5y to > 90y). The sample was 42% female and 28% had major comorbidities. Types of hematologic malignancies were 354 (34%) acute leukemia/MDS, 255 (25%) lymphoma, 206 (20%) plasma cell dyscrasia (myeloma/amyloid/POEMS), 116 (11%) CLL, 98 (10%) myeloproliferative neoplasm (MPN). Most pts (73%) received cancer treatment during the previous year, 9% had a pre-COVID-19 prognosis of <6months, and 10% deferred ICU care. COVID-19 mortality in the entire cohort was 17%. In multivariable analyses, age > 60 (OR 2.03, 1.31-3.18), male sex (OR 1.69, 1.11 – 2.61), estimated pre-COVID-19 prognosis of less than 6 months (OR 6.16, 3.26 – 11.70) and ICU deferral (OR 10.87, 6.36 – 18.96) were all independently associated with an increased risk of death. Receiving cancer treatment in the year prior to COVID-19 diagnosis and type of hematologic malignancy were not significantly associated with death. In multivariable analyses, age > 60 (OR 2.46, 1.83 – 3.31), male sex (OR 1.34, 1.02 – 1.76), estimated pre-COVID-19 prognosis of < 6 months (OR 4.81, 2.45 – 10.50), presence of a major comorbidity (OR 1.57, 1.15 – 2.16), and cancer treatment in the previous year (OR 1.50, 1.10 – 2.06) were all independently associated with an increased risk of a severe COVID-19 requiring hospitalization. Pts with a MPN or plasma cell dyscrasia and COVID-19 were less likely to require hospitalization for COVID-19 compared to patients with CLL, leukemia/MDS, or lymphoma.

CONCLUSIONS: These analyses confirm the negative impact of age > 60, male sex, pre-COVID-19 prognosis of < 6 months, and deferral of ICU care on mortality among patients with hematologic malignancy and COVID-19. We did not observe an increased risk of COVID-19 mortality among pts with COVID-19 who received blood cancer treatment in the previous year, although rate of hospitalization was higher. Pts with some hematologic malignancies (MPN, plasma cell dyscrasias), may experience less severe COVID-19 infections than others.

Disclosures: Anderson: Amgen: Consultancy; Mana Therapeutics: Current holder of individual stocks in a privately-held company, Membership on an entity's Board of Directors or advisory committees; AstraZeneca: Consultancy; Pfizer: Consultancy; Janssen: Consultancy; Oncopep: Current holder of individual stocks in a privately-held company, Membership on an entity's Board of Directors or advisory committees. Desai: Janssen R&D: Research Funding; Astex: Research Funding; Kura Oncology: Consultancy; Agios: Consultancy; Bristol Myers Squibb: Consultancy; Takeda: Consultancy. Goldberg: Celularity: Research Funding; Genentech: Consultancy, Membership on an entity's Board of Directors or advisory committees; Astellas: Consultancy, Membership on an entity's Board of Directors or advisory committees; Aptose: Consultancy, Research Funding; Prelude Therapeutics: Research Funding; DAVA Oncology: Honoraria; Pfizer: Research Funding; Arog: Research Funding; Aprea: Research Funding; AbbVie: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding. Neuberg: Madrigal Pharmaceuticals: Other: Stock ownership; Pharmacyclics: Research Funding. Radhakrishnan: Janssen India: Honoraria; Dr Reddy's Laboratories: Honoraria, Membership on an entity's Board of Directors or advisory committees; Aurigene: Speakers Bureau; Novartis: Honoraria; Johnson and Johnson: Honoraria; Pfizer: Consultancy, Honoraria; Astrazeneca: Consultancy, Honoraria; Emcure Pharmaceuticals: Other: payment to institute; Cipla Pharmaceuticals: Honoraria, Other: payment to institute; Bristol Myers Squibb: Other: payment to institute; Roche: Honoraria, Other: payment to institute; Intas Pharmaceutical: Other: payment to institute; NATCO Pharmaceuticals: Research Funding. Sehn: Debiopharm: Consultancy; Genmab: Consultancy; Novartis: Consultancy; Teva: Consultancy, Research Funding; Roche/Genentech: Consultancy, Research Funding; AbbVie: Consultancy; Acerta: Consultancy; Amgen: Consultancy; Apobiologix: Consultancy; AstraZeneca: Consultancy; Celgene: Consultancy; Gilead: Consultancy; Incyte: Consultancy; Janssen: Consultancy; Kite: Consultancy; Karyopharm: Consultancy; Lundbeck: Consultancy; Merck: Consultancy; Morphosys: Consultancy; Sandoz: Consultancy; Seattle Genetics: Consultancy; Takeda: Consultancy; TG Therapeutics: Consultancy; Verastem: Consultancy. Sekeres: Novartis: Membership on an entity's Board of Directors or advisory committees; Takeda/Millenium: Membership on an entity's Board of Directors or advisory committees; BMS: Membership on an entity's Board of Directors or advisory committees. Tallman: Oncolyze: Membership on an entity's Board of Directors or advisory committees; Jazz Pharma: Membership on an entity's Board of Directors or advisory committees; Roche: Membership on an entity's Board of Directors or advisory committees; Biosight: Membership on an entity's Board of Directors or advisory committees; Novartis: Membership on an entity's Board of Directors or advisory committees; Innate Pharma: Membership on an entity's Board of Directors or advisory committees; Syros: Membership on an entity's Board of Directors or advisory committees; Kura: Membership on an entity's Board of Directors or advisory committees; NYU Grand Rounds: Honoraria; Mayo Clinic: Honoraria; UC DAVIS: Honoraria; Northwell Grand Rounds: Honoraria; NYU Grand Rounds: Honoraria; Danbury Hospital Tumor Board: Honoraria; Acute Leukemia Forum: Honoraria; Miami Leukemia Symposium: Honoraria; New Orleans Cancer Symposium: Honoraria; KAHR: Membership on an entity's Board of Directors or advisory committees; Orsenix: Membership on an entity's Board of Directors or advisory committees; Daiichi-Sankyo: Membership on an entity's Board of Directors or advisory committees; Abbvie: Membership on an entity's Board of Directors or advisory committees; Amgen: Research Funding; Rafael Pharmaceuticals: Research Funding; Glycomimetics: Research Funding; Biosight: Research Funding; Orsenix: Research Funding; Abbvie: Research Funding; ASH: Honoraria; NCCN: Honoraria. Wood: Pfizer: Research Funding; Teladoc: Consultancy; Koneksa Health: Consultancy, Current equity holder in publicly-traded company; Genentech: Research Funding.

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*signifies non-member of ASH