COVID-19 in patients with hematological malignancies

Abstract

In most cases, COVID-19 is characterized by a mild clinical course. However, there are groups of patients at high risk of mortality and morbidity of COVID-19, including groups comprising older age (> 65 years), diabetes, hypertension, obesity, cancer, and hematological malignancies. Hematological patients are at high risk due to disease-related immune disorders and treatment-related factors. This review aims to summarize studies on COVID-19 in patients with the most common hematological neoplasms. We describe the fatality rate of COVID-19, the risk of severe disease, the efficacy and side effects of vaccines against COVID-19, and vaccine-drug interactions in chronic lymphocytic leukemia (CLL), multiple myeloma (MM), acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), diffuse large B cell lymphoma (DLBCL) as well as chronic myeloid leukemia (CML). We focus mainly on the use of mRNA vaccines, not other types of vaccines. Hematological patients are a priority group for vaccination against COVID-19, but serological response varies according to the type of hematological malignancy, with better responses in myeloid malignancies and poorer responses in CLL and lymphoma patients. Extended studies are needed to answer questions about a limited response to vaccines and the use of booster doses in CLL and patients treated with anti-CD38 therapy, BTKi therapy, anti-CD20 antibody or ruxolitinib therapy, as well as patients with non-Hodgkin lymphoma (NHL).