Increased Mortality Risk Seen in Older Patients With B-Cell Malignancies Who Contracted the COVID-19 Virus

Older patients undergoing treatment for B-cell malignancies who contracted the COVID-19 virus were at an increased risk of death vs patients with other cancers under the age of 60 years.

Older patients with B-cell malignancies and are receiving treatment for their disease who contracted the COVID-19 virus were found to a have higher risk of death than patients with other types of cancers, according to results from the American Society of Clinical Oncology Survey on COVID-19 in Oncology Registry study (NCT04659135) published in JCO Oncology Practice.1

Patients aged 61 to 70 years with B-cell malignancies were twice as likely to die from the virus (HR, 2.1; 95% CI, 1.3-3.3) and patients over the age of 70 had a 4.5 times greater mortality risk (95% CI, 1.8-11.1) compared with patients aged 60 years or younger. Tobacco users undergoing cancer treatment who were diagnosed with COVID-19 before June 2020 had an increased risk of 30-day mortality (20%; 95% CI, 14%-25%) compared with patients who were diagnosed on or after June 2020 (13%; 95% CI, 8%-18%; P = .08).2

In order to be eligible, patients needed to have a positive COVID-19 test and had active cancer for which they were receiving treatment or receiving adjuvant treatment for a cancer resected within the last 12 months.

The registry study collected data on demographics, risk factors, disease type, covid-19 infection, and mortality. The primary focus of the research was 30- and 90-day mortality. Patient outcomes were examined separately both before and after June 1, 2020.

A total of 453 patients met the inclusion criteria from the registry of 755 who were entered in the registry, 53% of whom had metastatic solid tumors, 38% had hematologic malignancies, and 9% had regional solid tumors. The most common diagnoses were multiple myeloma (17%), metastatic lung cancer (11%), and metastatic breast cancer (11%). Most patients were White (61%) and female (53%), with a median age of 64 years for the overall population.

Before data cutoff, 95 patients had died. Sixty-one percent of deaths were attributable to COVID-19 or related complications and 22% of deaths attributed to disease progression.

For patients with metastatic solid tumors aged 61 to 70 years, no significant increase in mortality risk was observed compared with patients of the same malignancy aged 60 years or younger (HR, 1.29; 95% CI, 0.93-1.79). Similar results were observed when comparing patients over 70 years old and patients 60 years and younger (HR, 1.67; 95% CI, 0.87-3.19).

At 30- and 90-days, the all-cause mortality rates for the overall patient population were 16% (95% CI, 12%-20%) and 24% (95% CI, 20%-29%), respectively. The 90-day mortality rate was 28% (95% CI, 21%-34%) compared with 21% (95% CI, 13%-28%) for patients diagnosed before June and during or after June, respectively (P = .20).

“Patients in the United States diagnosed with SARS-CoV-2 during the first 6 months of 2020 were more likely to receive intensive COVID-19 interventions and were at greater mortality risk. Delays and discontinuations of cancer treatment were common, and future analyses will provide more in-depth analysis of these data,” the investigators concluded.

References

  1. Mileham KF, Bruinooge SS, Aggarwal C, et al. Changes over time in COVID-19 severity and mortality in patients undergoing cancer treatment in the United States: initial report from the ASCO Registry. Published online October 25, 2021. JCO Oncol Pract. doi:10.1200/OP.21.00394
  2. Mortality risk in patients with cancer and SARS-CoV-2 higher among older patients with B-cell malignancies, and those who previously or currently smoke, according to new study. News release. American Society of Clinical Oncology. October 26, 2021. Accessed October 28, 2021. https://tinyurl.com/44es4zmr