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

• Published in: JCO global oncology Vol. 7; no. 7; pp. 577 - 584
• Main Authors: Demichelis-Gómez, Roberta, Alvarado-Ibarra, Martha, Vasquez-Chávez, Jule, Delgado-López, Nancy, Gómez-Cortés, Cynthia, Espinosa-Bautista, Karla, Cooke-Tapia, Ana, Milán-Salvatierra, Andrea, Gómez-De León, Andrés, Lee-Tsai, Yu Ling, Rosales-López, Daniel, Cabrera-García, Álvaro, Amador-Medina, Fabián, Córdoba-Ramírez, Alejandra, Murrieta-Álvarez, Iván, Solís-Poblano, Juan Carlos, Apodaca-Chávez, Elia, Rangel-Patiño, Juan, Álvarez-Vera, José Luis, Arana-Luna, Luara, De la Peña-Celaya, José Antonio, Espitia-Ríos, María Eugenia, Hernández-Ruiz, Eleazar, Pérez-Zúñiga, Juan Manuel, Peña-López, Estefanía, González-Rivera, Rosa, García-Leyva, María Fernanda, Tejeda-Romero, Mónica, Cruz-Rico, Jorge, Balderas-Delgado, Carolina, Ruíz-Argüelles, Guillermo J, Gómez-Almaguer, David
• Format: Journal Article
• Language: English
• Published: United States Wolters Kluwer Health 01-04-2021; American Society of Clinical Oncology
• Subjects: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Comorbidity; COVID-19 - epidemiology; COVID-19 - prevention & control; COVID-19 - virology; Epidemics; Female; Guatemala - epidemiology; Humans; Leukemia, Myeloid - diagnosis; Leukemia, Myeloid - epidemiology; Leukemia, Myeloid - therapy; Male; Medical Oncology - methods; Mexico - epidemiology; Middle Aged; ORIGINAL REPORTS; Panama - epidemiology; Peru - epidemiology; Prospective Studies; SARS-CoV-2 - isolation & purification; SARS-CoV-2 - physiology; Young Adult; Guatemala; Mexico; Peru; Panama
• ISSN: 2687-8941; 2687-8941
• DOI: 10.1200/GO.20.00620

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.
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.
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];
< .001), while the use of telemedicine was identified as a protective factor (odds ratio 0.36 [95% CI, 0.18 to 0.82];
= .014).
These results highlight the collateral damage of COVID-19 in oncology patients.