Report on management approaches and treatment results in chronic myeloid leukemia associated with SARS-CoV-2 infection

1 COVID-19 occurs commonly in working-age CML patients under the treatment with different generations of TKIs, especially in older males. 2 Patients without hematological response experienced an unfavorable evolution of both diseases: CML and SARS-CoV-2 infection. An increasing number of publications suggested a higher susceptibility of patients with leukemias to COVID-19 infection as compared to the allegedly healthy population. The aim of the study was to assess the epidemiological, clinico-biological features and management outcomes of CML in association with COVID-19. This analytical study included 20 CML patients with SARS-CoV-2 infection, who were treated at the Institute of Oncology from Moldova between 2020-2023. These CML patients with COVID-19 represented 13.2% of 151 patients followed up under TKIs treatment. According to the WHO classification of COVID-19, mild forms were recorded in 5 (25.0%) cases, moderate in 10 (50.0%) and severe in 5 (25.0%) cases. No correlation was found between the duration of CML and the severity of COVID-19. SARS-CoV-2 infection occurred during the treatment with imatinib in 12 (60.0%) cases, nilotinib in 5 (25.0%) and ponatinib in 3 (15.0%). All 5 (25.0%) patients with severe and 7 (35.0%) with moderate forms were hospitalized for treatment of COVID-19. Viral pneumonia emerged in 9 (45.0%) patients. SARS-CoV-2 infection developed commonly in older males with the advanced CML phases. There was no significant difference in morbidity by COVID-19 in patients under 75 years of age, treated with various generations of TKIs.