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

• DOI: 10.1200/go.20.00620
• Publication Date: 2021-04-23T20:01:30Z
• Authors: Roberta Demicheli...; Martha Alvarado-I...; Jule Vasquez-Chávez; Nancy Delgado-López; Cynthia Gómez-Cortés; Karla Espinosa-Ba...; Ana Cooke-Tapia; Andrea Milán-Salv...; Andrés Gómez-De León; Yu Ling Lee-Tsai; Daniel Rosales-López; Álvaro Cabrera-Ga...; Fabián Amador-Medina; Alejandra Córdoba...; Iván Murrieta-Álv...; Juan Carlos Solís...; Elia Apodaca-Chávez; Juan Rangel-Patiño; José Luis Álvarez...; Luara Arana-Luna; José Antonio De l...; María Eugenia Esp...; Eleazar Hernández...; Juan Manuel Pérez...; Estefanía Peña-López; Rosa González-Rivera; María Fernanda Ga...; Mónica Tejeda-Romero; Jorge Cruz-Rico; Carolina Balderas...; Guillermo J. Ruíz...; David Gómez-Almaguer

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