CLL-033 Is COVID-19 Infection a Trigger for Progression of CLL?

Abstract

Introduction: COVID-19 diagnosed in chronic lymphocytic leukemia (CLL) could have a severe evolution with many complications. Chemo immunotherapy and immunological status could be the main causes of this evolution. The aim of this study was to check if COVID-19 could associate with a progression of CLL. Materials and Methods: The retrospective study included 40 CLL patients (33 male and 7 female) with a median age of 64.5 (95% CI for median: 59-67) who were admitted to the Hematology Department Colentina between March 2020- March 2022). These patients were diagnosed with COVID-19 by PCR test and were evaluated from 2020 to 2022. Results High count of leucocytes (WBC)- more than 50 × 1000/µL was identified in 15 patients (37.5%). Persistence of hyperleukocytosis after 1 month of evolution was identified in 10 patients, in 7 of them starting treatment was needed, all these patients were in the watch and wait for the group before the onset of COVID-19. Infection of SARS-Cov-2 diagnosed in CLL patients was associated with refractory status and progression of CLL during the follow-up period, a switch to another line of treatment was needed. Long COVID is defined as persistence long time for symptoms and the positivity of the PCR test was directly correlated with an immune deficit (r=0.37, p=0.01). Thrombotic complication developed by CLL patients during COVID-19 evolution was associated with vascular risk presence (diabetes mellitus, arterial hypertension, thrombosis history- stroke or myocardial infarction) –(r=0.61, p=0.0001). Unfavorable evolution was highly correlated with high severity of pneumonia/respiratory insufficiency and immune deficiency presence; the high count of WBC at the onset or during the first month of COVID-19 was not associated with a high risk of deceased. Conclusion COVID-19 could be a trigger for the progression of CLL. A strong analysis of the high cohort is needed. The immune deficit is involved in the severity of COVID-19 and the unfavorable evolution of the patients. Vascular risk presence in CLL patients is associated with thrombotic complication.