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Covid-19 in patients with haematological malignancies

Hubert Warda1, Katarzyna Skórka1, Krzysztof Giannopoulos1

Abstract

In most cases, the COVID-19 is characterized by mild clinical course, however, there are groups of patients at high risk of mortality and morbidity of COVID-19, including the older age group (>65 years), diabetes, hypertension, obesity, cancer as well as haematological malignancies. Hematological patients are at high risk due to disease-related immune disorders and treatment-related factors. This review aimed to summarize studies on COVID-19 in patients with the most common haematological neoplasms. We described the fatality rate of COVID-19, risk of severe disease, the efficacy and side effects of the vaccine against COVID-19, and vaccine-drug interactions in chronic lymphocytic leukaemia (CLL), multiple myeloma (MM), acute myeloid leukaemia (AML), myelodysplastic syndrome (MDS), diffuse large B cell lymphoma (DLBCL) as well as chronic myeloid disorders. We focused mainly on the use of mRNA vaccines, not the other types of vaccines. Hematological patients are a priority group for vaccination against COVID-19, but serological response varied according to type of hematologic malignancy, with better responses in myeloid malignancies and lower responses observed in CLL and lymphoma patients. Extended studies are needed that will answer the question about limited response to vaccines and the utilization of booster doses in CLL and patients treated with anti-CD38 therapy, BTKi therapy, anti-CD20 antibody or ruxolitinib therapy as well as patients with Non-Hodgkin lymphoma (NHL).

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