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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

Steffanoni, 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.

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 Thumbnail


Authors

Sara Steffanoni

Teresa Calimeri

Alice Laurenge

CHRIS FOX Christopher.Fox@nottingham.ac.uk
Clinical Professor in Haematology

Carole Soussain

Christian Grommes

Maria Chiara Tisi

Jesca Boot

Nicola Crosbie

Carlo Visco

Luca Arcaini

Sridhar Chaganti

Marianna C. Sassone

Alvaro Alencar

Daniele Armiento

Ilaria Romano

Jorg Dietrich

Gilad Itchaki

Riccardo Bruna

Nicola S. Fracchiolla

Laura Arletti

Adriano Venditti

Stephen Booth

Pellegrino Musto

Khê Hoang Xuan

Tracy T Batchelor

Kate Cwynarski

Andrés J. M. Ferreri



Abstract

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.

Journal Article Type Article
Acceptance Date Jul 22, 2022
Online Publication Date Aug 9, 2022
Publication Date Nov 9, 2022
Deposit Date Jan 11, 2023
Publicly Available Date Jan 11, 2023
Journal British Journal of Haematology
Print ISSN 0007-1048
Electronic ISSN 1365-2141
Peer Reviewed Peer Reviewed
Volume 199
Issue 4
Pages 507-519
DOI https://doi.org/10.1111/bjh.18396
Public URL https://nottingham-repository.worktribe.com/output/15933356
Publisher URL https://onlinelibrary.wiley.com/doi/10.1111/bjh.18396

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