Treating Acute Leukemia During the COVID-19 Pandemic in an Environment With Limited Resources: A Multicenter Experience in Four Latin American Countries

JCO Glob Oncol. 2021 Apr:7:577-584. doi: 10.1200/GO.20.00620.

Abstract

Purpose: The COVID-19 pandemic is a colossal challenge for global health; nonetheless, specific subgroups face considerably higher risks for infection and mortality. Among patients with malignant diseases, those with hematologic neoplasms are at a higher risk for poor outcomes. The objective of this study was to register treatment modifications associated with the COVID-19 pandemic and their short-term consequences in Latin America.

Methods: Multicenter, prospective, observational, cohort study including patients older than 14 years from 14 centers in four countries (Mexico, Peru, Guatemala, and Panama) who had a confirmed diagnosis of acute leukemia, and who were undergoing active treatment since the first COVID-19 case in each country until the cutoff on July 15, 2020.

Results: We recruited 635 patients. Treatment modifications because of the COVID-19 pandemic were reported in 40.8% of cases. The main reason for such modifications was logistic issues (55.0%) and the most frequent modification was chemotherapy delay (42.0%). A total of 13.1% patients developed COVID-19 disease, with a mortality of 37.7%. Several factors were identified as independently associated with mortality, including a diagnosis of acute myeloid leukemia (odds ratio 2.38 [95% CI, 1.47 to 3.84]; P < .001), while the use of telemedicine was identified as a protective factor (odds ratio 0.36 [95% CI, 0.18 to 0.82]; P = .014).

Conclusion: These results highlight the collateral damage of COVID-19 in oncology patients.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 / epidemiology
  • COVID-19 / prevention & control*
  • COVID-19 / virology
  • Comorbidity
  • Epidemics
  • Female
  • Guatemala / epidemiology
  • Humans
  • Leukemia, Myeloid / diagnosis
  • Leukemia, Myeloid / epidemiology
  • Leukemia, Myeloid / therapy*
  • Male
  • Medical Oncology / methods*
  • Mexico / epidemiology
  • Middle Aged
  • Panama / epidemiology
  • Peru / epidemiology
  • Prospective Studies
  • SARS-CoV-2 / isolation & purification*
  • SARS-CoV-2 / physiology
  • Young Adult