Chronic Lymphocytic Leukemia in the SARS-CoV-2 Pandemic.

Content Provider	Europe PMC
Author	Arellano-Llamas, Abril Adriana Vela-Ojeda, Jorge Hernandez-Caballero, Alvaro
Abstract	Purpose of ReviewChronic lymphocytic leukemia (CLL) is the most frequent lymphoproliferative disease in the elderly of the western world. Immune defective responses and treatment can worsen the immune system’s competence of CLL patients. Consequently, they may present a higher incidence of recurrent severe infections, second malignancies, and reduced efficacy of vaccines. The outbreak of COVID-19 is an ongoing pandemic, and patients with comorbidities experience more severe forms of the disease. Hematological malignancies are associated with higher case fatality rates (CFRs) than other cancers. Knowledge about COVID-19 incidence, clinical course, and immune response to the infection and vaccination in CLL may contribute to design strategies that improve the outcomes of patients in the future.Recent FindingsThe prevalence of SARS-CoV-2 positivity in CLL is not significantly higher than seen in the general population. CFRs for CLL patients are 16.5-fold more elevated than the median reported worldwide and even higher in older patients, those who require hospitalization have significant comorbidities or need oxygen therapy. CLL status decreases the anti-SARS-CoV-2 positivity after infection or vaccination by around 40%, and the spike-specific antibody titers are 74-fold lower than healthy age-matched controls. The response rate to COVID-19 vaccines is even worse in patients with active CLL-directed therapies like BTKi, BCL-2 antagonists, or anti-CD20 monoclonal antibodies.SummaryCLL patients are at a greater risk of death from COVID-19. Inherent immunosuppression of CLL and immune deficiencies caused by treatment significantly decrease the ability to produce natural or vaccine-induced anti-SARS-CoV-2 immune responses.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8778499&blobtype=pdf
ISSN	15233790
Journal	Current Oncology Reports [Curr Oncol Rep]
Volume Number	24
DOI	10.1007/s11912-022-01198-z
PubMed Central reference number	PMC8778499
Issue Number	2
PubMed reference number	35061199
e-ISSN	15346269
Language	English
Publisher	Springer US
Publisher Date	2022-01-21
Publisher Place	New York
Access Restriction	Open
Rights License	This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022
Subject Keyword	SARS-CoV-2 COVID-19 CLL Chronic lymphocytic leukemia Antibody Vaccine BTK inhibitors
Content Type	Text
Resource Type	Article
Subject	Oncology