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Are Patients With Hematologic Cancers More Vulnerable to the Effects of COVID-19?


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A new study from the UK Coronavirus Cancer Monitoring Project (UKCCMP) has found that, compared with patients who have other malignancies, patients with blood cancers are more vulnerable to the effects of COVID-19 infection. These results were published by Lee et al in The Lancet Oncology.

As COVID-19 spread globally in early 2020, patients with cancer were identified as a subgroup who were potentially at an increased risk of infection of COVID-19 and of potentially suffering more serious disease consequences. It was this concern that led to the formation of the national UKCCMP project. Since March, more than 60 cancer centers across the United Kingdom have entered data into the UKCCMP database with information on adult patients with cancer who also contracted COVID-19. The project was set up to help researchers and clinicians better understand what groups of patients are most at risk of severe COVID-19 infection.

Study Findings

Using demographic data such as age, sex, and tumor type, researchers were able to determine that patients with hematologic cancers (leukemia, lymphoma, and multiple myeloma), particularly older patients and those with leukemia, had a more severe COVID-19 trajectory compared to patients with solid organ tumors.

The study found that patients with blood cancer were particularly at risk, with 57% higher odds of severe disease if they contract COVID-19. This was when compared to patients with other kinds of malignancies, such as breast cancer, who were shown to have the lowest risk overall.

Age was also shown to play a factor in the overall outcome, with patients over the age of 80 found to have the highest frequency of fatality.

After adjustment for age and sex, patients with hematologic malignancies who had recent chemotherapy had an increased risk of death during COVID-19-associated hospital admission.

As cancer treatments need to carry on during the pandemic, this study gives clinicians and patients important information to make informed decisions about treatment. The production of risk tables for different cancer types will also let doctors discuss the risks and benefits with patients, so that together they can pick the best way to treat each person’s cancer. The study also gives an evidence base from which hospitals and other health-care providers can design measures to ensure that they maintain access to life-saving treatments as safely as possible.

Senior study researcher Rachel Kerr, MBChB, of the University of Oxford, said, “Using these new data, we are working fast to identify trends and correlations, which will enable us to create a tiered risk assessment tool so we can more precisely define the risk to a given patient and move away from a blanket ‘vulnerable’ policy for all [patients with] cancer, in the event of a second wave of COVID-19.”

First study author Lennard Lee, DPhil, an academic clinical lecturer at the University of Oxford, added, “For the first time, we have a comprehensive analysis to determine who is more at risk of COVID-19. It is important to note that whilst patients [with cancer] are more vulnerable, the chance of any given patient getting infected with COVID-19 remains low. People with cancer can be reassured that everything is being done in UK cancer centers to effectively minimize the risk of infection so that life-saving treatments can continue to be given.”

Disclosure: For full disclosures of the study authors, visit thelancet.com.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
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