Differences in Clinical Course and Management of Sars-CoV2 Infection in Patients with Chronic Lymphocytic Leukemia between the Sequential Pandemic Phases: An Eric Study

Visentin, Andrea

Oral and Poster Abstracts
Oral
642. Chronic Lymphocytic Leukemia: Clinical and Epidemiological: Drugs in Development and COVID-19

Research, Lymphoid Leukemias, adult, epidemiology, CLL, Clinical Research, Diseases, real-world evidence, Lymphoid Malignancies, Human

Andrea Visentin, MD, PhD¹^*, Lydia Scarfo, MD²^*, Thomas Chatzikonstantinou, MD³^*, Anargyros Kapetanakis⁴^*, Christos Demosthenous⁵^*, Georgios Karakatsoulis⁶^*, Martin Andres, MD⁷^*, Darko Antic, PhD⁸^*, David Allsup, MD⁹^*, Mónica Baile¹⁰^*, Dominique Bron, MD PhD^11,12, Antonella Capasso¹³^*, Mark Catherwood, PhD¹⁴^*, Rosa Collado¹⁵^*, Raul Cordoba, MD, PhD¹⁶, Carolina Cuéllar-García¹⁷^*, Julio Delgado, MD, PhD^18,19^*, Maria Dimou²⁰, Michael Doubek, MD, PhD²¹, Lorenzo De Paoli, MD²²^*, Maria Rosaria De Paolis²³^*, Giovanni Del Poeta, MD²⁴^*, Maria Efstathopoulou²⁵^*, El-Ashwah Shimaa²⁶^*, Alicia Enrico²⁷^*, Lucia Farina²⁸^*, Angela Ferrari²⁹^*, Myriam Foglietta, MD³⁰^*, Moritz Furstenau, MD³¹, Jose A. Garcia-Marco³², Massimo Gentile, MD³³^*, Eva Gimeno³⁴^*, Gomes da Silva Maria³⁵^*, Odit Gutwein, MD³⁶^*, Yervand Hakobyan, PhD³⁷^*, Yair Herishanu³⁸^*, jose Angel Hernandez, MD³⁹^*, Tobias Herold, MD⁴⁰, Sunil Iyengar⁴¹^*, Gilad Itchaki⁴²^*, Ozren Jaksic, MD, PhD⁴³, Ann Janssens, MD, PhD⁴⁴^*, Olga Kalashnikova, MD⁴⁵^*, Elzbieta Kalicinska⁴⁶^*, Arnon P. Kater, MD, PhD⁴⁷, Sabina Kersting, MD, PhD⁴⁸^*, Jorge Labrador^49,50^*, Deepesh Lad, MD, DM⁵¹, Luca Laurenti, MD⁵²^*, Mark-David Levin⁵³, Enrico Lista, MD⁵⁴^*, Lara Malerba⁵⁵^*, Roberto Marasca, MD⁵⁶, Monia Marchetti⁵⁷^*, Juan Marquet Palomanes, MD⁵⁸^*, Mattias Mattsson, MD, PhD⁵⁹^*, Francesca Romana Mauro, MD⁶⁰^*, Carlota Mayor-Bastida⁶¹^*, Marta Morawska, MD⁶²^*, Marina Motta, MD⁶³^*, Talha Munir, MBBS, MRCP, FRCPath, PhD^64,65^*, Roberta Murru⁶⁶^*, Ivana Milosevic⁶⁷^*, Fatima Miras Calvo, MD⁶⁸^*, Carsten Utoft Niemann, MD, PhD⁶⁹, Jacopo Olivieri⁷⁰^*, Lorella Orsucci, MD⁷¹^*, Maria Papaioannou⁷²^*, Miguel Arturo Pavlovsky⁷³, Inga S. Piskunova⁷⁴^*, Barbara Pocali, MD⁷⁵^*, Viola Maria Popov, MD, PhD, MSc⁷⁶, Francesca Maria Quaglia⁷⁷^*, Giulia Quaresmini⁷⁸^*, Doreen te Raa, MD, PhD⁷⁹^*, Gianluigi Reda, MD⁸⁰^*, Gian Matteo Rigolin^81,82^*, Rosa Ruchlemer, MD⁸³^*, Amit Shrestha, MD⁸⁴^*, Martin Šimkovič⁸⁵^*, Martin Špaček⁸⁶^*, Paolo Sportoletti, MD⁸⁷^*, Oana Stanca Ciocan, MD⁸⁸^*, Tamar Tadmor, MD⁸⁹^*, Elisabeth Vandenberghe, MD, PhD⁹⁰^*, Marzia Varettoni, MD⁹¹^*, Candida Vitale⁹²^*, Ellen Van Der Spek⁹³^*, Michel Van Gelder, MD, PhD⁹⁴, Ewa Wasik-Szczepanek⁹⁵^*, Lucrecia Yáñez, MD, PhD⁹⁶^*, Mohamed A Yassin, MBBS, MSC, CABM, MSC, FACP⁹⁷, Marta Coscia⁹⁸^*, Barbara Eichhorst, MD⁹⁹, Alessandro Rambaldi, MD¹⁰⁰, Niki Stavroyianni¹⁰¹^*, Livio Trentin¹, Kostas Stamatopoulos, MD, PhD¹⁰²^* and Paolo Ghia, MD, PhD¹⁰³

¹Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Padova, Italy
²Università Vita-salute San Raffaele and IRCC Ospedale San Raffaele, Milan, Italy
³Hematology Department and HCT Unit, George Papanicolaou Hospital, Thessaloniki, GRC
⁴Institute of Applied Biosciences, Centre For Research and Technology Hellas, Thessaloniki, GRC
⁵Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Gree, Thessaloniki, GRC
⁶Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
⁷Department of Hematology and Central Hematology Laboratory, University Hospital/Inselspital Bern, University of Bern, Switzerland, Bern, Switzerland
⁸Clinic for hematology, Clinical Center of Serbia, Beograd, Serbia
⁹Centre for Atherothrombosis and Metabolic Disease, Hull York Medical School, Hull, United Kingdom
¹⁰Hospital Universitario de Salamanca/IBSAL, CIBERONC and Center for Cancer Research, Salamanca, Spain
¹¹Dpt of Hematology, Institut Jules Bordet, ULB, 1 Rue Heger Bordet, Belgium
¹²Department of Hematology, Institut Jules Bordet (ULB), Brussels, Belgium
¹³IRCCS Ospedale San Raffaele, Milano, Italy
¹⁴Haematology Department, Belfast City Hospital, Belfast, United Kingdom
¹⁵Department of Hematology, Hospital General Universitario, Valencia, Spain
¹⁶Lymphoma Unit, Department of Hematology, Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
¹⁷Hematology Unit Terrassa Hospital, Terrasa, Spain
¹⁸Department of Hematology, Hospital Clínic of Barcelona, Barcelona, Spain
¹⁹Hospital Clínic of Barcelona, Barcelona, Spain
²⁰1st Internal Medicine Department, Propaedeutic, Hematology Clinical Trial Unit, National and Kapodistrian University of Athens, Athens, Greece
²¹Department of Internal Medicine - Hematology and Oncology, University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
²²Division of Hematology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
²³UOC Ematologia PO Vito Fazzi, Lecce, Italy
²⁴Hematology, Department of Biomedicine, University Tor Vergata Roma, Italy, Rome, Italy
²⁵Iatriko Medical Center, Athens, Greece
²⁶Clinical Hematology Unit, Oncology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
²⁷Hospital Italiano La Plata, La Plata, Argentina
²⁸Hematology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
²⁹Ematologia, AO Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
³⁰SC Ematologia, AO S. Croce e Carle, Cuneo, Italy
³¹Department I of Internal Medicine and Center of Integrated Oncology ABCD Cologne, German CLL Study Group, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany, Cologne, Germany
³²Hematology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Spain
³³Hematology Unit AO Cosenza, Cosenza, Italy
³⁴Laboratoris de Citogenètica Molecular i Citologia Hematològica, Servei de Patologia i Servei Hematologia, Hospital del Mar, Barcelona, Spain
³⁵Division of Hematology, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal
³⁶Asaf Harophe Medical Center, Rishon Lezion, Israel
³⁷Hematology Center, Yerevan, Armenia
³⁸Tel-Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Tel-Aviv, ISR
³⁹Hospital Universitario Infanta Leonor, Madrid, Spain
⁴⁰Laboratory for Leukemia Diagnostics, Department of Medicine III, Ludwig-maximilians-Universitaet (LMU), Munich, Bavaria, Germany
⁴¹Royal Marsden Hospital, London, United Kingdom
⁴²Division of Hematology, Rabin Medical Center, Petah Tikva, and the Sackler School of Medicine, Tel-Aviv University, Petah Tikva, Israel
⁴³Division of Hematolog, Dubrava University Hospital, Zagreb, Croatia
⁴⁴Department of Hematology, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
⁴⁵Federal State Budgetary Educational Institution of Higher Education Academician I.P., Pavlov First St. Petersburg State Medical University of the Ministry of Healthcare of Russian Federation, St. Petersburg, RUS
⁴⁶Department and Clinic of Hematology, Blood Neoplasms and Bone Marrow Transplanta, Wroclaw, Poland
⁴⁷Department of Hematology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
⁴⁸Department of Hematology, Haga Teaching Hospital, The Hague, Netherlands
⁴⁹Hematology Department, Research Unit, Hospital Universitario de Burgos, Burgos, Spain
⁵⁰Hospital Universitario de Burgos, Burgos, Burgos, Spain
⁵¹Postgraduate Institute of Medical Education and Research, Chandigarh, India
⁵²Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
⁵³Department of Internal Medicine, Albert Schweitzer hospital, Dordrecht, Netherlands
⁵⁴Hematology unit, Hospital of Trento, Trento, Italy
⁵⁵Hematology and Stem Cell Transplant Center Marche Nord Hospital, Pesaro, Italy
⁵⁶Dept of Medical Sciences, Section of Hematology, University of Modena and Reggio Emilia, Modena, Italy
⁵⁷Division of Hematology, Hospital Antonio e Biagio and Cesare Arrigo, Alessandria, Italy
⁵⁸Hematology Service, Hospital Universitario Ramón y Cajal, Madrid, 28012, Spain
⁵⁹Department of Hematology and Department of Immunology, Genetics and Pathology, Uppsala University Hospital, Uppsala, Sweden
⁶⁰Hematology, Department of Translational and Precision Medicine, Sapienza University, Policlinico Umberto I, Roma, Italy
⁶¹La Princesa University Hospital, Madrid, Spain
⁶²Experimental Hemato-oncology Department, Medical University of Lublin, Lublin, Poland
⁶³SC Ematologia, ASST Spedali Civili di Brescia, Brescia, Italy
⁶⁴Department of Haematology, St James’s University Hospital, Leeds, United Kingdom
⁶⁵Consultant Haematologist, St James's Hospital, Leeds, United Kingdom
⁶⁶Hospital A. Businco, ARNAS “G. Brotzu”, Cagliari, CAGLIARI, Italy
⁶⁷University of Novi Sad, Novi Sad, Serbia
⁶⁸Hospital 12 de Octubre, Madrid, Spain
⁶⁹Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
⁷⁰Clinica Ematologica, Centro Trapianti e Terapie Cellulari "Carlo Melzi", Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
⁷¹Division of Hematology, Azienda Ospedaliera e Universitaria Città della Salute e della Scienza, Torino, Italy
⁷²First Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
⁷³FUNDALEU, Clinical research center Buenos Aires, Buenos Aires, Argentina
⁷⁴Consultative Hematology Department with a Day Hospital for Intensive High-Dose Chemotherapy, National Research Center for Hematology, Moscow, Russian Federation
⁷⁵Division of Hematology and Stem Cell Transplantation Unit, Cardarelli Hospital, Naples, Italy
⁷⁶Hematology, Colentina Clinical Hospital, Bucharest, Arges, Romania
⁷⁷Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
⁷⁸Hematology, ASST Papa Giovanni XXIII, Bergamo, Italy
⁷⁹Department of hematology, Gelderse Vallei, Ede, Netherlands
⁸⁰Hematology unit, Hematology Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico of Milan, Milan, Italy
⁸¹St. Anna University Hospital, Ferrara, Italy
⁸²Hematology section, Department of Medical Sciences, Azienda Ospedaliera- Universitaria, Arcispedale S. Anna, University of Ferrara, Ferrara, Italy
⁸³Department of Hematology, Shaare-Zedek Medical Center, affiliated with the Hebrew University Medical School, Jerusalem, Israel
⁸⁴Civil Service Hospital, Kathmandu, Nepal
⁸⁵4th Department of Internal Medicine – Haematology, Faculty of Medicine in Hradec Králové, University Hospital and Charles University in Prague, Hradec Kralove, Czech Republic
⁸⁶1st Department of Medicine - Hematology, First Faculty of Medicine, Charles University and General Hospital in Prague, Prague, Czech Republic
⁸⁷Department of Medicine, Division of Hematology and Clinical Immunology, University of Perugia, Perugia, Italy
⁸⁸Coltea Clinical Hospital, Bucharest, Romania
⁸⁹Bnai Zion Medical Center, Haifa, Israel
⁹⁰Haematology Department, St. James Hospital, Dublin, Ireland
⁹¹Division of Hematology Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
⁹²Division of Hematology, A.O.U. Cittàdella Salute e dellaScienza di Torino and Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, TX, Italy
⁹³Rijnstate hospital, department of internal medicine Arnhem, Arnhem, Netherlands
⁹⁴Department of Hematology, University Hospital Maastricht, Maastricht, Netherlands
⁹⁵Dept. Hematooncology and Bone Marrow Transplantation Medical University in Lublin, Lublin, Poland
⁹⁶Hematology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
⁹⁷Department of Medical Oncology/ Hematology Section, National Centre For Cancer Care & Research, Doha, Qatar
⁹⁸Division of Hematology, A.O.U. Cittàdella Salute e dellaScienza di Torino and Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
⁹⁹Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, German CLL Study Group, University of Cologne, Cologne, Germany
¹⁰⁰University of Milan, Bergamo, Italy
¹⁰¹Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
¹⁰²Institute of Applied Biosciences, Centre For Research and Technology Hellas, Thessaloniki, Greece
¹⁰³Universita' Vita-Salute San Raffaele C.F. 97187560152, Milano, MI, Italy

BACKGROUND. Infection by SARS-CoV2 remains a worldwide health burden. Previous studies by the ERIC (European Research Initiative on CLL) showed that patients with chronic lymphocytic leukemia (CLL) have a very-high risk of severe Coronavirus disease 19 (COVID19). In particular, age, CLL-directed treatment, and cardiac failure were identified as significant risk factors of overall survival (OS). Since the beginning of 2020 different treatment strategies have been used to fight COVID19 and different SARS-CoV2 variants alternated during the pandemic, however very few studies analyzed their impact on patients with CLL.

AIMS. The aims of this study were to investigate different manifestations, treatments and outcome of COVID19 in patients with CLL/SLL (small lymphocytic lymphoma), and MBL (monoclonal B-cell lymphocytosis).

METHODS. This is a retrospective international multicenter ERIC study from Jan 2020 till May 2022. CLL diagnosis, COVID-19 management, review of medical history, and assessment of patient status were performed by local investigators following international guidelines. Ninety institutions participated in the study. Statistical analyses were conducted using R software. During the pandemic we identified 4 phases: 1^st Jan 2020 - Jun 2020, 2^nd Jul 2020 - Feb 2021, 3^rd Mar 2021 - Dec 2021 and 4^th Jan 2022 - May 2022.

RESULTS. We gathered data from 1540 patients (93.8% CLL, 4.1% SLL and 2.1% MBL), 65% males, the median age at COVID19 was 69 years, median CIRS score was 4 (IQR 2-7), 49.6% were treated in the last 12 months before COVID19, 38.8% was on treatment at COVID19 onset (BTK inhibitor-based 51.1%, BCL2 inhibitor-based 20.7%, chemo/chemoimmunotherapy 21.5%, 6.7% others). Overall, 34.4% of patients was managed at home, 49.9% needed hospitalization and 15.7% was admitted to the intensive care unit (ICU). After a median follow-up of 2.7 months, the infection was resolved in 1124/1540 (73%) cases, while 23% died and 3.6% were still under medical observation.

Distribution of patients among time is shown in Fig. 1A. Three hundred and four (19.8%) patients were infected during the 1^st, 737 (48%) during the 2^nd, 137 (8.9%) during the 3^rd and 357 (23.3%) during the last 4^th phase.

Comparing the features of patients infected in different phases, age at COVID19 and distribution of biological markers were similar, but more patients in the latter phases suffered from arrhythmias (8.2% vs 10.5% vs 16.1% vs 14.2%, p=0.01), chronic renal disease (3.9% vs 5.9% vs 8.9% and 11.1%, p=0.003) and other malignancies (0.3% vs 1.8% vs 2.2% vs 3.6%, p=0.04). Vaccinated patients (0% vs 0.4% vs 45.7% vs 89.1%, p<0.001) and those treated for CLL in the last 12 months (44.1% vs 44.1% vs 55.7% vs 66.1%, p<0.001) were also more common in the last phases.

COVID19 signs and symptoms differed between early and late phases, with less fever (p<0.001) and dyspnea (p=0.028) but more fatigue (p<0.001), cough (p<0.001), headache (p<0.001), anosmia/ageusia (p<0.001) and myalgia/arthralgia (p<0.001) in the later phases.

COVID19 management also changed over time, with less patients receiving a SARS-CoV2 therapy (87.6% vs 74.7% vs 78.1% vs 67.9%, p<0.001). In particular, hydroxychloroquine, azithromycin, steroids and anti-IL6/IL6R were more commonly used in the first 2 phases while antiviral and monoclonal antibodies (mAb) were mainly employed in the last 2 phases. Less patients were hospitalized (84.5% vs 67.3% vs 60.3% vs 45.8%, p<0.001), needed ICU admission (20.6% vs 17.2% vs 13.3% vs 8.1%, p<0.001) or died (29.8% vs 25.5% vs 21.8% vs 15.8%, p=0.002) through these phases. These improvements in patients’ management led to an increase of OS, with 2-month OS of 70%, 74%, 81% and 83% for patients diagnosed during the 1^st, 2^nd,3^rd and 4^th phase (p=0.0015, Fig. 1B).

CONCLUSION. We analyzed one of the largest series of patients with CLL infected by SARS-CoV2 over more than 2 years of COVID19 pandemic. Patients infected during the most recent phases, though carrying a higher comorbidity burden, were less frequently hospitalized, only rarely needed ICU admission and died due to the SARS-CoV2 infection in a lower proportion compared to initial phases. The improvement in COVID-19 management with effective antiviral drugs, mAb and the high rate of vaccination together with the change in SARS-CoV2 variants over time may have played an important role in this outcome.

AV, LS, TC, AK, CD and GK equally contributed. KS and PG are both last authors.

Disclosures: Visentin: Janssen, Abbvie, CSL Behring: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Beigene: Membership on an entity's Board of Directors or advisory committees, Research Funding; AstraZeneca: Consultancy; Gilead: Consultancy; Takeda: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding. Scarfo: AbbVie, AstraZeneca, Janssen, Beigene, Lilly: Honoraria; BeiGene, Janssen: Other: Travel Grant; Octapharma: Speakers Bureau. Andres: Abbvie: Membership on an entity's Board of Directors or advisory committees, Other: Travel Support; AstraZeneca: Membership on an entity's Board of Directors or advisory committees, Other: Travel Support; Janssen-Cilag: Membership on an entity's Board of Directors or advisory committees, Other: Travel Support. Cordoba: BeiGene: Consultancy; Janssen: Consultancy, Honoraria, Speakers Bureau; Incyte: Consultancy; GenMab: Consultancy; Takeda: Consultancy; Kite: Consultancy, Speakers Bureau; Pfizer: Research Funding; Bristol Myers Squibb: Consultancy, Honoraria; Celgene: Honoraria; Gilead: Honoraria; Lilly: Consultancy; AstraZeneca: Consultancy, Honoraria, Speakers Bureau; AbbVie: Consultancy, Honoraria, Speakers Bureau; Roche: Consultancy, Honoraria, Speakers Bureau. Doubek: AbbVie: Honoraria; AOP Orphan: Consultancy, Research Funding; AstraZeneca: Consultancy, Honoraria, Research Funding; Janssen: Honoraria. Hernandez: Janssen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Roche: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Abbvie: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; AstraZeneca: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Beigene: Membership on an entity's Board of Directors or advisory committees; Lilly: Membership on an entity's Board of Directors or advisory committees; Gilead: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; BMS/Celgene: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Amgen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Takeda: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Jazz: Membership on an entity's Board of Directors or advisory committees; Rovi: Membership on an entity's Board of Directors or advisory committees; Incyte: Membership on an entity's Board of Directors or advisory committees. Iyengar: Janssen: Speakers Bureau; AbbVie: Other: conference support; Takeda: Membership on an entity's Board of Directors or advisory committees, Other: conference support, Speakers Bureau; Lilly: Membership on an entity's Board of Directors or advisory committees; Beigene: Membership on an entity's Board of Directors or advisory committees; Kite Gilead: Membership on an entity's Board of Directors or advisory committees. Itchaki: AstraZeneca: Consultancy; Janssen: Consultancy; Abbvie: Consultancy. Jaksic: Astra Zeneca: Consultancy, Speakers Bureau; Abbvie: Speakers Bureau; Johnson and Johnson: Speakers Bureau. Janssens: Genmab: Current Employment; Abbvie: Consultancy, Other: Travel Grants, Speakers Bureau; Amgen: Consultancy, Other: travel grants, Speakers Bureau; Astra-Zeneca: Consultancy, Speakers Bureau; Beigene: Consultancy, Speakers Bureau; Janssen: Consultancy, Speakers Bureau; Incyte: Consultancy, Speakers Bureau; Novartis: Consultancy, Speakers Bureau; Sobi: Consultancy, Speakers Bureau; Sanofi Genzyme: Consultancy, Speakers Bureau; Roche: Consultancy; Celgene: Other: travel grants. Kater: BMS: Membership on an entity's Board of Directors or advisory committees, Research Funding; Janssen: Membership on an entity's Board of Directors or advisory committees, Other: speakers fee, Patents & Royalties: pending, Research Funding; Roche/genentech: Membership on an entity's Board of Directors or advisory committees; LAVA: Membership on an entity's Board of Directors or advisory committees, Patents & Royalties: pending; Astra Zeneca: Membership on an entity's Board of Directors or advisory committees, Other: speakers fee, Research Funding; Abbvie: Membership on an entity's Board of Directors or advisory committees, Other: speakers fee, Research Funding. Levin: AbbVie, Roche and Janssen: Other: Travel expenses. Mauro: Janssen, Astra Zeneca, Beigene: Consultancy, Honoraria; Abbvie, Takeda: Honoraria, Research Funding, Speakers Bureau. Munir: Janssen, AstraZeneca, Alexion, Sobi, Novartis, Roche, Abbvie, Gilead: Honoraria; Janssen, AstraZeneca, Alexion, Abbvie, Novartis, Roche: Membership on an entity's Board of Directors or advisory committees. Murru: Janssen: Research Funding; Janssen, Abbvie, Astra Zeneca: Honoraria, Other: travel. Niemann: Takeda: Consultancy; CSL Behring: Consultancy; Octapharma: Consultancy, Research Funding; Janssen: Consultancy; AstraZeneca: Consultancy, Research Funding; Abbvie: Consultancy, Research Funding; Beigene: Consultancy; Genmab: Consultancy. Pavlovsky: AstraZeneca: Other; AbbVie: Other: Conference; AbbVie: Membership on an entity's Board of Directors or advisory committees; Janssen: Membership on an entity's Board of Directors or advisory committees; Janssen: Other: Conference; Raffo: Membership on an entity's Board of Directors or advisory committees; AstraZeneca: Membership on an entity's Board of Directors or advisory committees. Reda: Janssen, Abbive, Astra Zeneca, Beigene: Consultancy. Rigolin: Abbvie: Honoraria; AstraZeneca: Honoraria; Janssen: Honoraria; Gilead: Honoraria, Research Funding. Šimkovič: Gilead: Current holder of stock options in a privately-held company; AstraZeneca: Consultancy, Current holder of stock options in a privately-held company, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses; BeiGene: Current holder of stock options in a privately-held company; AbbVie: Consultancy, Current holder of stock options in a privately-held company, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses; Janssen-Cilag: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses; J&J: Current holder of stock options in a privately-held company; Baxter: Current holder of stock options in a privately-held company; Novartis: Current holder of stock options in a privately-held company; Abbot: Current holder of stock options in a privately-held company; Sanofi: Current holder of stock options in a privately-held company. Tadmor: Janssen: Research Funding; AbbVie, Roche, Novartis, Sanofi, Takeda, Janssen, Pfizer: Consultancy, Honoraria, Speakers Bureau. Varettoni: ABBVIE: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: travel expenses; ASTRAZENECA: Membership on an entity's Board of Directors or advisory committees; BEIGENE: Membership on an entity's Board of Directors or advisory committees, Other: travel expenses; JANNSEN: Membership on an entity's Board of Directors or advisory committees, Other: travel expenses. Eichhorst: Janssen, AbbVie, Lilly, AstraZeneca, BeiGene, MSD: Consultancy; Janssen, Roche, AbbVie, BeiGene, AstraZeneca, MSD: Speakers Bureau; Beigene: Other: Travel Support; Janssen, Roche, AbbVie, BeiGene, AstraZeneca: Research Funding. Rambaldi: Roche: Honoraria; Incyte: Honoraria; Novartis: Honoraria; Kite-Gilead: Honoraria; Jazz: Honoraria; ABBVIE: Honoraria; Astellas: Honoraria; Pfizer: Honoraria; Amgen: Honoraria; Janssen: Honoraria; Celgene-BMS: Honoraria; Omeros: Honoraria. Stamatopoulos: AbbVie: Research Funding. Ghia: BMS: Consultancy, Honoraria; Janssen: Consultancy, Honoraria, Research Funding; BeiGene: Consultancy, Honoraria; MSD: Consultancy, Honoraria; Roche: Consultancy, Honoraria; AstraZeneca: Consultancy, Honoraria, Research Funding; Lilly/Loxo: Consultancy, Honoraria; AbbVie: Consultancy, Honoraria, Research Funding.

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966 Differences in Clinical Course and Management of Sars-CoV2 Infection in Patients with Chronic Lymphocytic Leukemia between the Sequential Pandemic Phases: An Eric Study