key: cord-0880591-l845r7ce authors: Cuneo, Antonio; Rigolin, Gian Matteo; Coscia, Marta; Quaresmini, Giulia; Scarfò, Lydia; Mauro, Francesca Romana; Motta, Marina; Quaglia, Francesca Maria; Trentin, Livio; Ferrario, Andrea; Laurenti, Luca; Reda, Gianluigi; Ferrari, Angela; Pietrasanta, Daniela; Sportoletti, Paolo; Re, Francesca; De Paoli, Lorenzo; Foglietta, Myriam; Giordano, Annamaria; Marchetti, Monia; Farina, Lucia; Del Poeta, Giovanni; Varettoni, Marzia; Chiurazzi, Federico; Marasca, Roberto; Malerba, Lara; Ibatici, Adalberto; Tisi, Maria Chiara; Stefoni, Vittorio; Leone, Monica; Baratè, Claudia; Olivieri, Jacopo; Murru, Roberta; Gentile, Massimo; Sanna, Alessandro; Gozzetti, Alessandro; Gattei, Valter; Gottardi, Daniela; Derenzini, Enrico; Levato, Luciano; Orsucci, Lorella; Penna, Giuseppa; Chiarenza, Annalisa; Foà, Robin title: Management of chronic lymphocytic leukemia in Italy during a one year of the COVID‐19 pandemic and at the start of the vaccination program. A Campus CLL report date: 2021-07-13 journal: Hematol Oncol DOI: 10.1002/hon.2899 sha: c0e53a778ea4224fc005460a09e9a880c0705e25 doc_id: 880591 cord_uid: l845r7ce nan Twelve months after the outbreak of COVID-19, the Campus CLL network that involves hematology centers throughout Italy completed a survey (Tables 1 and 2) aimed at collecting information on the treatment of chronic lymphocytic leukemia (CLL) patients in the different phases of the pandemic -that is, phase 1 (February-May 2020), phase 2 (June-September 2020) and phase 3 (October 2020-January 2021), as well as on the vaccination program. During the year of the pandemic, 494 cases of COVID-19 infection were diagnosed among 15.039 CLL cases followed at 47 hematology centers, with a 12-month incidence of 3.3%. This value is comparable with that of the general population in Italy. The majority of CLLs with COVID-19 infection (64%) was observed in the phase 3, with northern regions observing fewer cases than in the phase 1 due to the high incidence observed during the outbreak of the pandemic. 1 The age of the patients and the type of anti-CLL treatment did not change significantly in the different phases of the pandemic. Because CLL is a disease affecting predominantly the elderly, it comes as no surprise that the median age of CLL patients with COVID-19 infection did not change over time, even though the infection in our country affected the younger population more frequently during the phase 3 (54.6% of the positive cases) than in the phase 1 (28.6%). The 25% mortality rate did not change significantly in the different phases of the pandemic and appears comparable with that observed previously. 2 We also documented a similar frequency of admissions requiring invasive oxygen support in the high incidence periods, with 21.4% and 20.2% of patients admitted to intensive care units in the phases 1 and 3, respectively. Our data documented that a higher proportion of patients was followed at home in the summer period (phase 2) compared to those managed during the phase 1 of the pandemic (65% of cases vs. 33.8%, p = 0.0096) and also during the phase 3 (39.9% vs. 33.8%, p = ns). These observations suggest that the implementation of outreach services with home care and mobile clinics 3 allowed to release the pressure in hospitals without negatively impacting on survival, especially in the summer period when the low prevalence of the disease enabled an accurate home care follow-up. The heterogeneous reports by the Campus CLL network on how to treat CLL patients during the reflects the lack of prospective studies. While a prudential treatment hold until recovery has been recommended for patients who develop a COVID-19 infection, 4 no treatment modification for patients with mild symptoms has been recommended in an online forum, where it was also reported that it is common practice to continue BTKis and withhold venetoclax in CLL patients diagnosed with COVID-19. 5 Interestingly, in a prospective study of CIT versus venetoclax-based regimens, 7 patients were diagnosed with COVID-19 and 5 recovered. 6 In Italy the vaccination policy for patients with hematologic malignancies is heterogeneous, with some hematology centers organizing the vaccination of their patients in the clinic and others The results of this 12-months analysis documented the overall low Chronic lymphocytic leukemia management in Italy during the COVID-19 pandemic: a Campus CLL report COVID-19 severity and mortality in patients with chronic lymphocytic leukemia: a joint study by ERIC, the European Research Initiative on CLL, and CLL Campus A community-based model to the COVID-19 humanitarian crisis How we manage patients with chronic lymphocytic leukemia during the SARS-CoV-2 pandemic COVID-19 and CLL: Frequently Asked Questions COVID-19 among fit patients with CLL treated with venetoclax-based combinations COVID19 and Cancer Clinical Trials Working Group. COVID-19 vaccine guidance for patients with cancer participating in oncology clinical trials Severe covid-19 COVID-19 vaccine efficacy in patients with chronic lymphocytic leukemia Efficacy of the BNT162b2 mRNA COVID-19 vaccine in patients with chronic lymphocytic leukemia Antonio Cuneo, Hematology Section, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.Email: cut@unife.it Antonio Cuneo and Gian Matteo Rigolin contributed equally. Data sharing not applicable to this article as no datasets were generated or analysed during the current study.