Treating Acute Leukemia During the COVID-19 Pandemic in an Environment With Limited Resources: A Multicenter Experience in Four Latin American Countries

• Autores: Demichelis-Gómez, R, Alvarado-Ibarra, M, Vasquez-Chávez, J, Delgado-López, N, Gómez-Cortés, C, Espinosa-Bautista, K, Cooke-Tapia, A, Milán-Salvatierra, A, Gómez-De León, A, Lee-Tsai, YL, Rosales-López, D, Cabrera-García, Á, Amador-Medina, F, Córdoba-Ramírez, A, Murrieta-Álvarez, I, Solís-Poblano, JC, Apodaca-Chávez, E, Rangel-Patiño, J, Álvarez-Vera, JL, Arana-Luna, L, De la Peña-Celaya, JA, Espitia-Ríos, ME, Hernández-Ruiz, E, Pérez-Zúñiga, JM, Peña-López, E, González-Rivera, R, García-Leyva, MF, Tejeda-Romero, M, Cruz-Rico, J, Balderas-Delgado, C, Ruíz-Argüelles, GJ, Gómez-Almaguer, D
• Formato: artículo
• Fecha de Publicación: 2021
• Institución: Instituto Nacional de Enfermedades Neoplásicas
• Repositorio: INEN-Institucional
• Lenguaje: inglés
• OAI Identifier: oai:repositorio.inen.sld.pe:20.500.14703/83
• Enlace del recurso: https://hdl.handle.net/20.500.14703/83
• Nivel de acceso: acceso abierto
• Materia: Acute Leukemia; COVID-19; https://purl.org/pe-repo/ocde/ford#3.02.21

Purpose: The COVID-19 pandemic is a colossal challenge for global health; nonetheless, specific subgroups face considerably higher risks for infection and mortality. Among patients with malignant diseases, those with hematologic neoplasms are at a higher risk for poor outcomes. The objective of this study was to register treatment modifications associated with the COVID-19 pandemic and their short-term consequences in Latin America. Methods: Multicenter, prospective, observational, cohort study including patients older than 14 years from 14 centers in four countries (Mexico, Peru, Guatemala, and Panama) who had a confirmed diagnosis of acute leukemia, and who were undergoing active treatment since the first COVID-19 case in each country until the cutoff on July 15, 2020. Results: We recruited 635 patients. Treatment modifications because of the COVID-19 pandemic were reported in 40.8% of cases. The main reason for such modifications was logistic issues (55.0%) and the most frequent modification was chemotherapy delay (42.0%). A total of 13.1% patients developed COVID-19 disease, with a mortality of 37.7%. Several factors were identified as independently associated with mortality, including a diagnosis of acute myeloid leukemia (odds ratio 2.38 [95% CI, 1.47 to 3.84]; P < .001), while the use of telemedicine was identified as a protective factor (odds ratio 0.36 [95% CI, 0.18 to 0.82]; P = .014). Conclusion: These results highlight the collateral damage of COVID-19 in oncology patients.