COVID-19 infection in acute lymphoblastic leukemia over 15 months of the pandemic. A Campus ALL report

The spread of coronavirus disease 2019 (COVID-19), with the two peaks of infection documented worldwide (Febrepresented a challenge in the management of patients with hematologic malignancies,1-3 typically immunosuppressed either because of their primary disease and/or because of treatment. This is particularly true among patients with acute lymphoblastic leukemia (ALL). However, given the rarity of this disease in adulthood, information is limited and based, so far, mainly on case reports,4-6 with only two larger series having been published.7,8 In order to define the clinico-biological features of the COVID-19-infected ALL population, and their ALL management and ALL outcome, as well as COVID-19-related variCOVID-19-related support and sequelae, we conducted a cross-sectional, observational study in 34 Italian hematology centers within the nationwide Campus ALL network. The protocol (ref. 2694CESC on 30-04-2020) was approved by the Ethics Committee of the coordinating center and by the local institutional review boards of participating centers. All patients gave written informed consent to participation in the study. With regard to the geographic distribution of the centers that participated in the study, 17 were located in the north of Italy, 11 in the center and six in southern Italy. The period covered by the survey spanned from February 2020, the start of the first wave of the pandemic, to April 2021, to include the second peak. Out of 756 adults with ALL (237 with Philadelphia chromosome [Ph]-positive ALL, 363 with Ph-negative B-ALL and 156 with T-ALL) actively followed during this 156.5-10.5) developed an infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), detected by molecular testing in all but one case. No patients had resurvey. All patients were monitored on a regular basis (in most centers every 3 days) if hospitalized, at hospital admission if outside, whereas for the few patients who were and/or were off-therapy (n=6), molecular testing was carried out if they had symptoms or they had a close contact with an infected individual. There was no preferential distribution among the various regions: 30 infections were documented in northern Italy, 19 in central Italy and 14 in southern Italy. Thus, the incidence of the infection in the ALL population in the geographical areas was 7%, 8% and

Automated summary

The management of patients with hematologic malignancies, particularly acute lymphoblastic leukemia (ALL), during the COVID-19 pandemic is challenging. This cross-sectional observational study conducted in Italian hematology centers explored the characteristics and management of COVID-19-infected ALL patients.