Outcomes of COVID-19 in CLL Patients

What Happens When Chronic Lymphocytic Leukemia Patients Contract COVID-19?

Chronic lymphocytic leukemia (CLL) causes a slow increase in the number of white blood cells in the bone marrow. The cancerous cells spread from the bone marrow to the blood and can also affect the lymph nodes and other organs. CLL eventually causes the bone marrow to fail and weakens the immune system.

Dr. Nitin Jain, of the University of Texas MD Anderson Cancer Center, explains CLL in detail in this Patient Power Ask the Expert video, What is Chronic Lymphocytic Leukemia?

Diagnosed with CLL and COVID-19

What happens when patients with chronic lymphocytic leukemia get COVID-19? Patient Power Co-Founder Andrew Schorr, who has been a CLL patient for 24 years, spoke to patient Heidi Yates, a CLL Facebook group leader who contracted COVID-19. She describes her experience as excruciating.

“The headache, for me, it was the worst part. It was like a migraine but like times 100. It was right behind your eyeball,” Heidi said. And unlike the flu, whose symptoms are constant, her COVID-19 symptoms would come and go. Fever, chills, and headaches would subside for a while and then come raging back.

Heidi was terrified. Both she and her husband had COVID-19 and felt miserable.

Heidi was bed-ridden for 14 days with body aches and with no clear end in sight. And yet there was a light at the end of the tunnel.

Around the two-week mark, she started to feel well enough to get tested again. This time, she tested negative.

Heidi beat COVID-19 at home and didn’t need hospitalization or oxygen. Lingering side effects include trouble breathing during her workouts. But, ultimately, this is a story of hope.

Research Data from Cancer Patients Around the World

Dr. Anthony Mato, a hematologist/oncologist at Memorial Sloan Kettering Cancer Center spoke with Andrew Schorr about recent research findings.

“The minute that we heard about this oncoming crisis, we started to gather some partners from around the world to examine the outcomes for patients with CLL who were diagnosed with COVID-19, recognizing that our patients are somewhat different than everybody else… they could be immunocompromised, they may be on active continuous therapy,” Dr. Mato said.

He and fellow researchers studied 198 CLL patients diagnosed with symptomatic COVID-19 across 43 international centers to see how they fared with both conditions between February 2020 and April 2020. Patient age and comorbidities (other health issues) were a factor in outcomes. Those needing hospitalization were patients with fever and shortness of breath who required oxygen support. Of those patients, 66 passed away.

Dr. Mato said that this serves as a baseline. More studies with larger data sets and longer follow-ups are needed to see if these kinds of numbers are the norm or outliers.

“We found that age, particularly age greater than 75, and patients who had multiple medical comorbidities measured by something called a SEER score were at a higher risk for dying from COVID-19,” he said. The Surveillance, Epidemiology, and End Results (SEER) Program is a National Cancer Institute project and provides information on cancer statistics in an effort to reduce the cancer burden.

Interestingly, there was not much difference in the “watch and wait” patients versus those on continuous therapy.

The Future of COVID-19 and CLL

Dr. Mato is interested in finding out if patients with CLL are making COVID-19 antibodies at the same rate as other patients. CLL is not a single disease so there are some variables that need to be explored to better understand the big picture.

“Having the antibody does not confer immunity,” Dr. Mato said.

While we eagerly wait for a successful vaccine and continue to wear masks for the safety of all our loved ones who are one sneeze away from danger, clinical trials and testing the vaccine are critical to ensure the safety of immunocompromised patients.

As far as prevention goes, Dr. Mato defers to the U.S. Food & Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) on their recommendations. Dr. Mato does not recommend trying any new medications or supplements outside of what your oncology team prescribes.

The future is bright, and we have a lot to be positive about when it comes to the state of health and medicine, even amid this pandemic.

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