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Impact of severe acute respiratory syndrome coronavirus‐2 infection on the outcome of primary central nervous system lymphoma treatment: A study of the International PCNSL Collaborative Group
Author(s) -
Steffai Sara,
Calimeri Teresa,
Laurenge Alice,
Fox Christopher P.,
Soussain Carole,
Grommes Christian,
Tisi Maria Chiara,
Boot Jesca,
Crosbie Nicola,
Visco Carlo,
Arcaini Luca,
Chaganti Sridhar,
Sassone Marianna C.,
Alencar Alvaro,
Armiento Daniele,
Romano Ilaria,
Dietrich Jorg,
Itchaki Gilad,
Bruna Riccardo,
Fracchiolla Nicola S.,
Arletti Laura,
Venditti Adriano,
Booth Stephen,
Musto Pellegrino,
Hoang Xuan Khê,
Batchelor Tracy T.,
Cwynarski Kate,
Ferreri Andrés J. M.
Publication year - 2022
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.18396
Subject(s) - medicine , pneumonia , chemotherapy , coronavirus , incidence (geometry) , immunology , disease , infectious disease (medical specialty) , covid-19 , physics , optics
Summary To optimise management of severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) infection identifying high‐risk patients and maintaining treatment dose intensity is an important issue in patients with aggressive lymphomas. In the present study, we report on the presentation, management, and outcome of an international series of 91 patients with primary central nervous system lymphoma and SARS‐CoV‐2 infection. SARS‐CoV‐2 was diagnosed before/during first‐line treatment in 64 patients, during follow‐up in 21, and during salvage therapy in six. Among the 64 patients infected before/during first‐line chemotherapy, 38 (59%) developed pneumonia and 26 (41%) did not clear the virus. Prolonged exposure to steroids before viral infection and/or treatment with high‐dose cytarabine favoured pneumonia development and virus persistence and were associated with poorer survival; 81% of patients who did not clear virus died early from coronavirus disease 2019 (COVID‐19). Vaccination was associated with lower pneumonia incidence and in‐hospital mortality. Chemotherapy was initiated/resumed in 43 (67%) patients, more commonly among patients who did not develop pneumonia, cleared the virus, or did not receive steroids during infection. Chemotherapy resumption in patients with viral persistence should be indicated cautiously as it was associated with a poorer survival (6‐month, 70% and 87%, p = 0.07). None of the 21 patients infected during follow‐up died from COVID‐19, requiring similar measures as infected subjects in the general population.