COVID-19 in patients with classic and variant hairy cell leukemia.

COVID-19 in patients with classic and variant hairy cell leukemia.

Publication date: Sep 20, 2023

Hairy cell leukemia (HCL), like its variant HCLv, is a B-cell malignancy associated with decreased humoral immunity. We prospectively monitored the largest cohort of HCL/HCLv patients to date (n=503) for COVID-19 by symptoms, antibody, PCR and/or antigen-positivity. Fifty percent (253 of 503) of the HCL/HCLv patients (238 HCL, 15 HCLv) had evidence of COVID-19, with 210 (83%) of 253 testing positive by PCR or rapid-antigen. Of 43 without positive tests, all had nucleocapsid antibodies indicating COVID-19 exposure, 7 recalled no symptoms, and 36 had mild symptoms but without a positive test. Of the 210 testing positive, 23, 46, 129 and 12 occurred in 2020, 2021, 2022 and 2023, respectively. Of 210 testing positive, 175 began treatment for HCL/HCLv 0. 4-429 (median 66) months before, and 132 had their last dose of anti-CD20 Mab 0. 2-229 (median 63) months before. Two patients died, including a young woman beginning rituximab 2 months after 1st-line cladribine before vaccine availability. Nearly all HCL/HCLv patients recovered uneventfully from COVID-19 including those without vaccination or those with significant immunosuppression and recent treatment. However, decreased normal B-cells from HCL or treatment was associated with lower spike antibody levels as a response to COVID-19 (p=0. 0094) and longer recovery time (p=0. 0036). Thus, in a large cohort of HCL/HCLv and the first to determine relationships between COVID-19 outcome and immune markers, mortality was relatively low (~1%), sequelae were uncommon, and recovery from COVID-19 was longer if normal B-cells were low after recent treatment.

Concepts Keywords
Hairy Antibody
Leukemia Cohort
Pcr Covid
Vaccination Decreased


Type Source Name
disease MESH COVID-19
disease MESH hairy cell leukemia
disease IDO cell
disease MESH malignancy
disease VO dose
drug DRUGBANK Rituximab
drug DRUGBANK Cladribine
disease VO vaccine
disease VO vaccination
disease IDO immunosuppression
disease VO time
disease MESH sequelae

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