P104 | Risk Factors and Outcomes of Patients With Chronic Lymphocytic Leukemia Who Experienced a Subsequent Covid-19 Event: a Retrospective Observational Study.
Year: 2025
Type: article
Abstract: During the early SARS-CoV-2 pandemic, patients with chronic lymphocytic leukemia (CLL) showed high vulnerability to COVID-19, resulting in high morbidity and mortality rates. The prolonged shedding of mutant variants has led to increased reinfection rates. We conducted a retrospective observational study at the Hematology Unit of the Sapienza University of Rome to evaluate among 220 patients with CLL who had experienced COVID-19 the characteristics and outcomes of those who developed a subsequent event between March 2020 and December 2024. Following the first COVID-19, 10/220 (4.5%) patients died. The median age of the 210 patients who survived the first event was 68 years; unmutated IGHV and TP53 disruption were detected in 45% and 23% of cases, respectively. A CIRS score ≥6 was observed in 16% of patients and 23% were on treatment with targeted agents. Notably, 87/210 (41.4%) had received at least one dose of the SARS-CoV-2 vaccine after the first COVID-19. Over 31.3 months of follow-up, 33.8% (71/210) had a subsequent COVID-19 event, occurring after a median time of 14.1 months from the first. All reinfections occurred during the Omicron and post-Omicron waves. Compared to subsequent COVID-19-free patients, those with a new COVID-19 event were more frequently on CLL treatment (34% vs. 17%; p=0.007). No differences were found in terms of Tixagevimab/cilgavimab prophylaxis (p=0.167) or additional vaccine doses (p=0.638). The 12-month-subsequent COVID-19 event-free survival (SCFS) was 77.4%. Independent risk factors associated to shorter SCFS were CIRS ≥6 (HR 2.20; p=0.003) and active CLL therapy (HR 1.92; p=0.010). Subsequent events showed more favourable outcomes than the first one in terms of rates of pneumonia (8.5% vs. 22.7%; p=0.008), hospitalization (7% vs. 25.9%; p=0.001), and fatal cases (0% vs. 4.5%; p=0.126). Focusing on reinfected patients, the median SCFS was longer for the 31 patients who had received at least one dose of vaccine after their first event than those who did not (16.3 vs. 9.3 months; p=0.001) (Figure 1). Our “real word” study reveals a 33.8% rate of new COVID-19 events in CLL patients, with high comorbidity and active treatment as significant risk factors for reinfection. Moreover, our data show that SARS-CoV-2 vaccination delays reinfection, supporting booster doses to extend infection-free intervals.
Authors: S. Pepe, R. Mazzarella, C. Andriola, T. Soriano, E. Antonini, G. Sforzini, F.R. Mauro.
Institution: Sapienza University of Rome
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7093121772
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