Citations 6
Fever of Unknown Origin Solved With Novel Diagnostic Tool
Pomerantz, Lauren , Saleh, Omar M. Abu, Griffin, Nick, Pomerantz, Lauren D , Saleh, Omar Abu , Griffin, Natalie E.
Annals of Internal Medicine: Clinical Cases | July 21, 2026 | Volume: 5 | Issue: 7 | Pages: No page available
Overall survival of patients with chronic lymphocytic leukemia treated with venetoclax-obinutuzumab compared to age- and sex-matched general population
Pomerantz, Lauren , Hampel, Paul J. , Roeker, Lindsey E., Bailen, Rachel J., Koehler, Amber B. , Wagner, Catherine C., Behnken, Amy L., Leis, Jose F., Schwager, Susan M., Zepeda‐Mendoza, Cinthya , Shi, Min, Hanson, Curtis A., Slager, S E, Braggio, Esteban, Kenderian, Saad J., Wang, Yucai, Parikh, S., Pomerantz, Lauren D , Rabe, Kari G. , Hampel, Paul J , Roeker, Lindsey E. , Bailen, Rachel, Behnken, Amy, Leis, José F., Hilal, Talal , Tsang, Mazie , Parrondo, Ricardo D , Schwager, Susan M., Shi, Min , Hanson, Curtis A. , Braggio, Esteban , Kay, Neil E. , Wang, Yucai , Parikh, Sameer A.
Leukemia & Lymphoma | June 25, 2026 | Volume: No volume available | Issue: No issue available | Pages: 1-5
Venetoclax-obinutuzumab in frontline and R/R CLL: Outcomes compared to age- and sex-matched general population
Pomerantz, Lauren , Hampel, Paul J. , Bailen, Rachel, Koehler, Amber B. , Coddington, Catherine, Behnken, Amy, Leis, José F., Schwager, Susan M., Achenbach, Sara J., Zepeda, Cinthya Mendoza, Hanson, Curtis A. , Parikh, Sameer A. , Rabe, Kari G. , Roeker, Lindsey E. , Kenderian, Saad S. , Kay, Neil E. , Coddington, Catherine, Hilal, Talal , Tsang, Mazie , Parrondo, Ricardo D , Shi, Min , Slager, Susan L. , Braggio, Esteban , Wang, Yucai
Blood | December 5, 2025 | Volume: 146 | Issue: Supplement 1 | Pages: 3905-3905
Abstract Background: The synergistic mechanisms of BCL-2 inhibitors and CD20-directed antibodies in the treatment of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) often lead to deep and durable responses. Although the use of venetoclax-obinutuzumab (Ven-O) in the frontline setting (1L) for CLL/SLL has led to a paradigm shift in the disease management, there are limited data on its efficacy in the relapsed/refractory (R/R) setting. In this study, we evaluated the efficacy and safety of Ven-O in both 1L and R/R CLL among patients treated outside the context of clinical trials at our institution. Methods We used the Mayo Clinic CLL Database to identify patients with CLL who were treated with Ven-O, both in 1L and R/R settings. Patients seen at Mayo Clinic Rochester between 2017 and 2025 were included. Overall survival (OS) was calculated from date of Ven-O initiation until last known alive date. Event-free survival (EFS) was calculated from date of Ven-O initiation until the next line of treatment or last known alive date. Kaplan-Meier methods estimated EFS and OS rates at 1, 3, and 5 years. Cox proportional hazards models were used to explore the association between baseline factors and EFS and OS; results are reported as hazard ratios (HR) and 95% confidence intervals (95%CI). Finally, we compared the OS to the age- and sex-matched general population of the state of Minnesota. Results A total of 154 patients (91 1L, 63 R/R) were included in the study. The median age was 68 years (69 1L, 68 R/R), and 68% were male (64% 1L, 73% R/R). Overall, TP53 disruptions (either del17p by FISH or TP53 mutation) were noted in 22 (15%) patients (9% 1L, 23% R/R). CLL FISH findings demonstrated del11q in 24 (19%) patients (19% 1L, 18% R/R), del13q in 46 (36%) patients (36% 1L, 36% R/R), and trisomy 12 in 21 (16%) patients (16% 1L, 18% R/R). IGHV genes were unmutated in 95 (68%) patients (60% 1L, 80% R/R). The CLL-IPI risk score was high in 54 (51%) patients (51% 1L, 53% R/R) and very-high in 18 (17%) patients (8% 1L, 34% R/R). A total of 121 (89%) patients completed planned treatment (1 year of venetoclax in 73 [90%] 1L and 2 years of venetoclax in 48 [87%] R/R). Median follow-up for the entire cohort was 1.8 years (2.2 1L, 1.5 R/R). Neither median EFS nor OS was reached for the overall cohort or within the 1L and R/R subgroups. The 1, 3, and 5-year EFS estimates for the overall cohort were 91% (86-96%), 85% (78-92%), and 67% (51-89%), respectively; corresponding EFS values for the 1L subgroup were 95% (91-100%), 89% (82-98%), and 67% (47-95%), respectively; and for the R/R subgroup were 85% (76-95%), 77% (65-92%), and 77% (65-92%), respectively. The 1, 3, and 5-year OS estimates were 98% (95-100%), 95% (91-99%), and 88% (76%-100%), respectively; corresponding OS values for the 1L subgroup were 99% (96-100%), 97% (94-100%), and 97% (94-100%) and for the R/R subgroup were 96% (91-100%), 91% (82-100%), and 61% (27-100%), respectively. Univariable analyses showed that TP53 disruption was associated with shorter EFS (HR 3.8, 95%CI 1.4-10.2, p=0.01), although IGHV mutation status was not associated with shorter EFS. A higher level of serum beta-2 microglobulin (HR 1.27, 95%CI 1.01-1.59, p=0.04) and R/R status (HR 4.9, 95%CI 0.9-25.8, p=0.06) were associated with a shorter OS. Interestingly, TP53 mutation status and IGHV mutation status were not associated with inferior OS. There was no difference in the observed and expected OS for both the 1L (p-0.23) and R/R (p=0.14) Ven-O treated cohorts compared to the age- and sex-matched general population of the state of Minnesota. Conclusions Our study shows that Ven-O is a well-tolerated regimen with demonstration of durable treatment responses both in the 1L and R/R groups, when used outside the context of a clinical trial. To the best of our knowledge, these data for the first time demonstrate no difference in OS of patients treated with Ven-O compared to age- and sex-matched general population, in both the 1L and R/R settings.
Personal protective beliefs and behaviors during the COVID-19 pandemic at a large, multi-campus, public university in Pennsylvania: a cross-sectional survey
Stachowski, J, Chen, William, Kim, Roxanne E. , Murphy, Ryan P, Pomerantz, Lauren , Don, Prabhani Kuruppumullage, Long, Bradley A. , Bell, Jill Stachowski, Murphy, Ryan
No container title available | September 24, 2024 | Volume: No volume available | Issue: No issue available | Pages: No page available
Abstract Introduction The COVID-19 pandemic impacted many higher education institutions. Understanding the personal protective beliefs and behaviors surrounding public health measures such as facemasking, social distancing, and handwashing helps to inform public health outreach measures. Objective This study evaluates the beliefs and occurrences of facemasking, social distancing, and handwashing behaviors among people at a multi-campus, public university in Pennsylvania. Methods From October 5 - November 30, 2021, a 10-minute REDCap survey was available to students, faculty, and staff 18 years of age and older at the Pennsylvania State University (PSU). Recruitment included targeted email, social media, digital advertisements, and university newspapers. 4,231 responses were received. Simple percentage associations between the selected factors and facemasking behaviors as well as beliefs on the origin of the COVID-19 virus were made with IBM SPSS Statistics, version 29.0.2.0 (20). Multivariable logistic regression analyses were performed using R statistical software to identify factors associated with facemasking, social distancing, and handwashing behaviors. Results Of 3,662 completed surveys, 65.2% of respondents were positive that facemasks prevented the transmission of airborne disease, 49.9% of the respondents stated that they wore facemasks always (27.9%), almost always (26.9%), or often (11.1%). 65.3% believed social distancing prevented transmission of COVID-19, 57.5% reported social distancing while on-campus or out in public (always: 18.8%, almost always: 20.3%, often: 18.4%). The response rate for some level of conscientiously washing hands for the 20 second duration was 87.5% (always: 26.0%, almost always: 31.9%, sometimes: 19.9%, only after being out in public: 4.9%, and only when convenient: 4.8%). Belief in effectiveness of personal protective measures was the strongest predictor of masking and social distancing behaviors. Faculty were more likely than students to report consistent masking, while other behaviors lacked this role-based significance. Social distancing was strongly associated with age and political views, and handwashing was strongly associated with gender. Conclusions Beliefs in public health and safety measures during the COVID-19 pandemic did not always match the behaviors of individuals surveyed. Understanding barriers to performing behaviors or public health safety may help inform future areas for targeted intervention. Adherence to personal protective behaviors varied across age, gender, institutional role, and political leaning, further emphasizing the importance of targeted public health education.
Systemic Anticancer Therapy and Thromboembolic Outcomes in Hospitalized Patients With Cancer and COVID-19
Hsu, Chih–Yuan , Shah, Surbhi, Zon, Rebecca L. , Alsamarai, Susan, El-Bakouny, Ziad, Beeghly, Alicia, Doroshow, Deborah B. , Flora, Daniel , Fromowitz, Ariel, Jani, Chinmay , Khan, Hina, Klein, Elizabeth J. , Heater, Natalie Knox , Koshkin, Vadim S. , Kwon, Daniel H. , McKay, Rana R. , Nonato, Taylor K., Polimera, Hyma , Puc, Matthew , Shastri, Aditi , Singh, Sunny , Weissmann, Lisa B., Wilkins, Cy R. , Yoon, James J., Mishra, Sanjay , Grivas, Petros , Connors, Jean M. , Gandhi, Rikin, Gartrell, Benjamin A. , Makower, Della , Sullivan, Darciann O', Ohri, Nitin , Verma, Amit , Butt, Omar H. , Fiala, Mark A. , Monahan, Ryan, Bitran, Jacob D. , Hallmeyer, Sigrun , Mundt, Daniel , Pandravada, Sasirekha, Papaioannou, Philip V., Patel, Mauli, Streckfuss, Mitrianna, Tadesse, Eyob, Lammers, Philip E. , Bindal, Poorva , Lam, Barbara C.C., Piper‐Vallillo, Andrew J., Arvanitis, Panos , Vieira, Kendra, Angevine, Anne H., Bär, Michael, Prete, Salvatore A. Del , Fiebach, Maryann Z., Gulati, Anthony P., Hatton, Edward H., Houston, Kaly, Lo, K. M. Steve, Stratton, Jamie , Weinstein, Paul L., García, Jorge A. , Routy, Bertrand , Hoyo-Ulloa, Irma , Gupta, Shilpa , Sharifi, Nima , Hoppenot, Claire , Demetri, George D., Zarif, Talal El , Freeman, Dory , Nohria, Anju, Tolaney, Sara M. , Zhang, Tian , Dzimitrowicz, Hannah, Leighton, John, Lynch, Ryan C. , Portuguese, Andrew J. , Schweizer, Michael T. , Vinayak, Shaveta , Wagner, Michael J. , Dansoa, Yvonne , Manikowski, Jesse J. , Vadakara, Joseph , Yossef, Kristena, Beckerman, Jennifer, Goyal, Sharad , Messing, Ian , Provenzano, Destie , Steffes, Dawn R., Clément, Jessica , Cosin, Jonathan A. , Daher, Ahmad , Dailey, Mark E., Hosmer, Wylie, Hsu, Emily , Jayaraj, Asha, Mather, Jeff, Menendez, Alvaro G. , Nadkarni, Rajani, Serrano, Oscar K. , Tejwani, Sheela , Accordino, Melissa , Bodin, Brianne E, Khan, Shaheer , Masson, Cynthia, Alexander, Mariam , Matar, Sara , Bernicker, Eric , Deeken, John F. , Jeffords, Kelly J., Shafer, Danielle , Cárdenas‐Delgado, Ana I., Campos, Rogelio Cuervo, Ramirez, Ana, Valdez-Reyes, Nadia Melissa, Gill, David , Lewis, Mark A. , Low, Clarke A., Rhodes, Terence D., Jones, Michelle, Mansoor, Abdul-Hai, Mashru, Sandeep H., Werner, Mica A., Cohen, Aaron , Hayes‐Lattin, Brandon , Nemecek, Eneida R. , Williamson, Staci, Lewis, Grant C., Smith, Stephanie J., Akhtari, Mojtaba, Castillo, Dan R., Cortez, Kimberly, Park, Kyu, Reeves, Mark E. , O’Connor, Timothy E. , Altman, Jessica K. , Gurley, Michael, Mulcahy, Mary F. , Kulkarni, Amit , Ramesh, Vidhyalakshmi , Wilson, Grace L. , Bardia, Aditya , Gainor, Justin F. , Peppercorn, Jeffrey , Reynolds, Kerry L. , Zubiri, Leyre , Campian, Jian , Riaz, Irbaz B, Williams, Colt , Bonnen, Mark , Mahadevan, Daruka , Salazar, Mary, Wang, Chen‐Pin , Bouganim, Nathaniel , Elkrief, Arielle , Moria, Feras, Panasci, Justin , Nanchal, Rahul , Bahadur, Nadia , Nambiar, Puja H. , Papadopoulos, Esperanza B. , Riely, Gregory J. , Rosenberg, Jonathan E., Cerrone, Kim, Dill, Jennifer A. , Faller, Bryan A. , Ajmera, Archana , Brouha, Sharon S. , Choi, Sharon , Bhatt, Padmanabh , Mariano, Melissa G., Thomson, Carey C. , Glace, Mary Grace, Knoble, Jeanna, Zacks, Rosemary, Blau, Sibel , Brown, CarrieAnn, Namburi, Swathi, Pomerantz, Lauren , Rovito, Marc A., Advani, Pragati E., Cronin, Tara, Fleissner, Bridget, Goel, Shipra , Gopalakrishnan, Dharmesh , Hernandez‐Ilizaliturri, Francisco J. , Kariapper, Ariffa, Levine, Ellis , Wicher, Camille P., Misdary, Christian, Shah, Mansi , Batist, Gerald , Cook, Erin , Esfahani, Khashayar , Ferrario, Cristiano , Lau, Susie , Ma, Kim, Rudski, Lawrence , Dutra, Míriam Santos , Mahmood, Sana , Mico, Vasil, Rivera, Andrea Verghese, Dixon, Becky, Heilman, Hannah, Logan, Barbara, Mandapakala, Chaitanya, Cabebe, Elwyn C., Glover, Michael , Jha, Alokkumar , Schapira, Lidia , Shah, Sumit , Subbiah, Suki , Lopes, Gilberto , Cardenas, Karen de, Russell, Karen , Stith, Brittany, Taylor, Sharona, Klamerus, Justin F., Revankar, Sanjay G. , Addison, Daniel , Chen, James L. , Pillainayagam, Clement, Wall, Sarah , Williams, Nicole , Abbasi, Saqib Hussen, Annis, Sandy, Greenland, Steven, Jones, Regina, Kasi, Anup , Rock, Crosby D. , Wulff‐Burchfield, Elizabeth , Smits, Melissa, Weiß, Matthias , Chism, David D. , Owenby, Susie, Ang, Celina , Galsky, Matthew D. , Metzger, Megan , Uyehara, Catherine, Lashley, Latoya N., Sueyoshi, Mark, Patel, Kanishka G. , Riess, Jonathan W. , Borno, Hala T. , Rubinstein, Samuel M. , Ahmad, Syed A. , Grover, Punita , Jandarov, Roman , Kharofa, Jordan , Marcum, Michelle, Sohal, Davendra , Zamulko, Olga , Balmaceda, Nicole , Geiger, Christopher L., Russ, Atlantis Dawn, Saker, Haneen , Choi, Horyun, Feldman, Lawrence , Gantt, Gerald, Hoskins, Kent , Khan, Mahir, Liu, Li , Nguyen, Ryan H., Schwartz, Candice, Venepalli, Neeta K. , Boldt, Anne, Fecher, Leslie A. , Su, Chris, Bijjula, Ragneel R., Mavromatis, Blanche H., Seletyn, Mildred E., Wood, Barbara R., Kaklamani, Virginia , Charles, Lawrence J., Cheng, Alex , Ding, Tan , Enriquez, Kyle T. , French, Benjamin , Gillaspie, Erin A. , Hennessy, Cassandra , Johnson, Douglas B. , Lewis, Judy T., Reid, Sonya , Saif, Sara, Slosky, David, Solórzano, Carmen C. , Sun, Tianyi , Yang, Yuanchu James , Carducci, Theresa M., Goldsmith, Karen J., Loon, Susan Van, Topaloĝlu, Ümit , Moore, Joan K., Cabalona, Wilhelmina D., Shisler, Elizabeth, McCollough, Briana Barrow, Peddi, Prakash , Rosen, L, Bilen, Mehmet Asım , Castellano, Cecilia A. , Ravindranathan, Deepak , LoRusso, Patricia , Lustberg, Maryam B. , Masters, Tyler, Mishra, Sanjay , Zubiri, Leyre , Fiala, Mark A , Bilen, Mehmet A , Portuguese, Andrew J , Lustberg, Maryam , Gulati, Shuchi , Shah, Pankil , Awosika, Joy A. , Bashir, Babar , Berg, Stephanie , De‐la‐Rosa‐Martinez, Daniel , Egan, Pamela , Fein, Joshua Alexander , Friese, Christopher R. , Griffiths, Elizabeth A. , Hwang, Clara , Joshi, Monika , Labaki, Chris , Latif, Tahir , Nagaraj, Gayathri , Nakasone, Elizabeth S. , Razavi, Pedram , Ruíz‐García, Erika , Saliby, Renée Maria , Tagalakis, Vicky , Vilar‐Compte, Diana , Wise-Draper, Trisha Michel , Wotman, Michael T. , Shyr, Yu , Warner, Jeremy L. , Shah, Dimpy P. , Rosovsky, Rachel , Goel, Sanjay , Halmos, Balázs , Sica, Roberto Alejandro , Henderson, Jeffrey P. , Stockerl‐Goldstein, Keith , Zhou, Alice Y. , Tadesse, Eyob, Thompson, Michael A. , Loree, Jonathan M. , Lam, Barbara, Peters, Mary Linton B , Farmakiotis, Dimitrios , Olszewski, Adam J. , Hatton, Edward, Rose, Suzanne J. , Nizam, Amanda , Pennell, Nathan A , Li, Ang , Bitterman, Danielle S. , Choueiri, Toni K. , Florez, Narjust , Giordano, Antonio , Morgans, Alicia K. , Nohria, Anju , Van Allen, Eliezer M , Xu, Wenxin Vincent , Halabi, Susan , Graber, Jerome J. , Hawley, Jessica E. , Loggers, Elizabeth T , Lyman, Gary H , Su, Christopher , Tachiki, Lisa , Yeh, Albert C. , Gatson, Na Tosha , Makary, Mina S. , Rao, Yuan James , Rosenstein, Lori J. , Elias, Rawad , Eton, Omar , Yu, Peter Paul , Gadgeel, Shirish M. , Bhutani, Divaya , Hershman, Dawn L. , Ingham, Matthew , Schwartz, Gary K. , Reuben, Daniel Y. , McWeeney, Shannon K. , Wehbe, Firas , Durbin, Eric B. , Nelson, Heather H. , Sachs, Zohar , Wilson, Grace, Boland, Genevieve M. , Smith, Katherine E. , Bekaii‐Saab, Tanios , Desai, Aakash , Hálfdánarson, Þorvarður R. , Joyner, Michael J. , Senefeld, Jonathon W. , Ramirez, Amelie G , Mesa, Ruben A. , Papenburg, Jesse , Vinh, Donald Cuong , Singh, Harpreet , Bao, Ting , O'Cearbhaill, Roisin E , Philip, John, Robson, Mark E. , Rosenberg, Jonathan E., Schoenfeld, Adam Jacob , Tamimi, Rulla M. , Dill, Jennifer, Hsiao, Albert , Reid, Erin G , Rink, Cameron L. , Jain, Prantesh , Moffitt, Melissa , O’Connor, Tracey L. , Puzanov, Igor , Smith, Laurie J., Zsíros, Emese , Jabbour, Salma K , Cook, Erin, Miller, Wilson H. , Wilchesky, Machelle , McNair, Christopher M. , Khaki, Ali Raza , Nagpal, Seema , Wu, Julie , Whaley, David, Gatti-Mays, Margaret Elena , Jhawar, Sachin R. , Palmer, Joshua D. , Stover, Daniel G. , Weiss, Matthias, Berenberg, Jeffrey L. , Fazio, Alyson, Huber, Kathryn E. , Small, Eric J. , Zhang, Sylvia , Andermann, Tessa M. , Jensen, Christopher Edward , Wood, William A. , Li, Ningjing , Abidi, Maheen Z. , Bowles, Daniel W. , Markham, Merry Jennifer , Acoba, Jared David , Rho, Young Soo, Nguyen, Ryan H., Pasquinelli, Mary M. , Vikas, Praveen , Zakharia, Yousef , Zaman, Qamar U., Brown, Alaina J. , Crispens, Marta Ann , Croessmann, Sarah , Davis, Elizabeth J. , Ding, Tan, Duda, Stephany N. , Hausrath, Daniel J. , Li, Xuanyi , Prescott, Lauren Shore , Wang, Lucy Lu , Aboulafia, David M. , Hafez, Navid , Herbst, Roy S. , Stratton, Catherine , Painter, Corrie , Peters, Solange
JAMA Oncology | August 17, 2023 | Volume: 9 | Issue: 10 | Pages: 1390
ImportanceSystematic data on the association between anticancer therapies and thromboembolic events (TEEs) in patients with COVID-19 are lacking.ObjectiveTo assess the association between anticancer therapy exposure within 3 months prior to COVID-19 and TEEs following COVID-19 diagnosis in patients with cancer.Design, Setting, and ParticipantsThis registry-based retrospective cohort study included patients who were hospitalized and had active cancer and laboratory-confirmed SARS-CoV-2 infection. Data were accrued from March 2020 to December 2021 and analyzed from December 2021 to October 2022.ExposureTreatments of interest (TOIs) (endocrine therapy, vascular endothelial growth factor inhibitors/tyrosine kinase inhibitors [VEGFis/TKIs], immunomodulators [IMiDs], immune checkpoint inhibitors [ICIs], chemotherapy) vs reference (no systemic therapy) in 3 months prior to COVID-19.Main Outcomes and MeasuresMain outcomes were (1) venous thromboembolism (VTE) and (2) arterial thromboembolism (ATE). Secondary outcome was severity of COVID-19 (rates of intensive care unit admission, mechanical ventilation, 30-day all-cause mortality following TEEs in TOI vs reference group) at 30-day follow-up.ResultsOf 4988 hospitalized patients with cancer (median [IQR] age, 69 [59-78] years; 2608 [52%] male), 1869 had received 1 or more TOIs. Incidence of VTE was higher in all TOI groups: endocrine therapy, 7%; VEGFis/TKIs, 10%; IMiDs, 8%; ICIs, 12%; and chemotherapy, 10%, compared with patients not receiving systemic therapies (6%). In multivariable log-binomial regression analyses, relative risk of VTE (adjusted risk ratio [aRR], 1.33; 95% CI, 1.04-1.69) but not ATE (aRR, 0.81; 95% CI, 0.56-1.16) was significantly higher in those exposed to all TOIs pooled together vs those with no exposure. Among individual drugs, ICIs were significantly associated with VTE (aRR, 1.45; 95% CI, 1.01-2.07). Also noted were significant associations between VTE and active and progressing cancer (aRR, 1.43; 95% CI, 1.01-2.03), history of VTE (aRR, 3.10; 95% CI, 2.38-4.04), and high-risk site of cancer (aRR, 1.42; 95% CI, 1.14-1.75). Black patients had a higher risk of TEEs (aRR, 1.24; 95% CI, 1.03-1.50) than White patients. Patients with TEEs had high intensive care unit admission (46%) and mechanical ventilation (31%) rates. Relative risk of death in patients with TEEs was higher in those exposed to TOIs vs not (aRR, 1.12; 95% CI, 0.91-1.38) and was significantly associated with poor performance status (aRR, 1.77; 95% CI, 1.30-2.40) and active/progressing cancer (aRR, 1.55; 95% CI, 1.13-2.13).Conclusions and RelevanceIn this cohort study, relative risk of developing VTE was high among patients receiving TOIs and varied by the type of therapy, underlying risk factors, and demographics, such as race and ethnicity. These findings highlight the need for close monitoring and perhaps personalized thromboprophylaxis to prevent morbidity and mortality associated with COVID-19–related thromboembolism in patients with cancer.
Interplay of Immunosuppression and Immunotherapy Among Patients With Cancer and COVID-19
Bakouny, Ziad , Grover, Punita , Hsu, Chih–Yuan , Alimohamed, Saif, Bilen, Mehmet Asım , Castellano, Cecilia A. , Desai, Aakash , Elkrief, Arielle , Eton, Omar , Fecher, Leslie A. , Flora, Daniel , Galsky, Matthew D. , Gesenhues, Alicia, Glover, Michael , Gopalakrishnan, Dharmesh , Gupta, Shilpa , Hayes‐Lattin, Brandon , Hendawi, Mohamed , Hsu, Emily , Jandarov, Roman , Jani, Chinmay , Johnson, Douglas B. , Khan, Hina, Khan, Shaheer , Koshkin, Vadim S. , Kulkarni, Amit , Kwon, Daniel H. , Matar, Sara , McKay, Rana R. , Mishra, Sanjay , Moria, Feras A., Nizam, Amanda , Nock, Nora L. , Nonato, Taylor K., Panasci, Justin , Pomerantz, Lauren , Portuguese, Andrew J. , Provenzano, Destie , Puc, Matthew , Rao, Yuan James , Rhodes, Terence D., Riely, Gregory J. , Ripp, Jacob , Rivera, Andrea Verghese, Shah, Sumit , Shaya, Justin , Subbiah, Suki , Tachiki, Lisa , Valdés-Reyes, Melissa , Weissmann, Lisa B., Wulff‐Burchfield, Elizabeth , Xie, Zhuoer , Yang, Yuanchu James , Shyr, Yu , Choueiri, Toni K. , Fromowitz, Ariel, Gandhi, Rikin, Gartrell, Benjamin A. , Makower, Della , Sullivan, Darciann O', Ohri, Nitin , Portes, Mary, Verma, Amit , Butt, Omar H. , Campian, Jian , Fiala, Mark A. , Monahan, Ryan, Bitran, Jacob D. , Hallmeyer, Sigrun , Mundt, Daniel , Pandravada, Sasirekha, Papaioannou, Philip V., Patel, Mauli, Streckfuss, Mitrianna, Tadesse, Eyob, Kundranda, Madappa N. , Lammers, Philip E. , Bindal, Poorva , Lam, Barbara C.C., Piper‐Vallillo, Andrew J., Arvanitis, Panos , Klein, Elizabeth J. , Vieira, Kendra, Angevine, Anne H., Bär, Michael, Prete, Salvatore A. Del , Fiebach, Maryann Z., Gulati, Anthony P., Hatton, Edward H., Houston, Kaly, Lo, K. M. Steve, Stratton, Jamie , Weinstein, Paul L., García, Jorge A. , Routy, Bertrand , Hoyo-Ulloa, Irma , Dawsey, Scott J. , Lemmon, Christopher A. , Sharifi, Nima , Granada, Carolina , Hoppenot, Claire , Connors, Jean M. , Demetri, George D., Freeman, Dory , Tolaney, Sara M. , Zon, Rebecca L. , Zhang, Tian , Dzimitrowicz, Hannah, Leighton, John, Grivas, Petros , Lynch, Ryan C. , Schweizer, Michael T. , Vinayak, Shaveta , Wagner, Michael J. , Dansoa, Yvonne , Manikowski, Jesse, Vadakara, Joseph , Yossef, Kristena, Beckerman, Jennifer, Goyal, Sharad , Messing, Ian , Steffes, Dawn R., Alsamarai, Susan, Clément, Jessica , Cosin, Jonathan A. , Daher, Ahmad , Dailey, Mark E., Hosmer, Wylie, Jayaraj, Asha, Mather, Jeff, Menendez, Alvaro G. , Nadkarni, Rajani, Serrano, Oscar K. , Yu, Peter Paul , Balanchivadze, Nino, Accordino, Melissa , Bodin, Brianne E, Masson, Cynthia, Alexander, Mariam P., Mushtaq, Sarah, Bernicker, Eric , Deeken, John F. , Jeffords, Kelly J., Shafer, Danielle , Cárdenas, Ana I, Campos, Rogelio Cuervo, Ramirez, Ana, Gill, David , Lewis, Mark A. , Low, Clarke A., Jones, Michelle M, Mansoor, Abdul-Hai, Mashru, Sandeep H., Werner, Mica A., Cohen, Aaron , Nemecek, Eneida R. , Williamson, Staci, Smith, Stephanie J., Lewis, Grant C., Zaren, Howard A. , Akhtari, Mojtaba, Castillo, Dan R., Cortez, Kimberly, Lau, Eric , Park, Kyu, Reeves, Mark E. , O’Connor, Timothy E. , Altman, Jessica K. , Gurley, Michael, Mulcahy, Mary F. , Ramesh, Vidhyalakshmi , Sachs, Zohar , Wilson, Grace, Bardia, Aditya , Gainor, Justin F. , Peppercorn, Jeffrey , Reynolds, Kerry L. , Zubiri, Leyre , Riaz, Irbaz B, Shah, Surbhi, Ayre, Susan K., Bonnen, Mark , Mahadevan, Daruka , McKeown, Cindy, Salazar, Mary, Wang, Chen‐Pin , Bouganim, Nathaniel , Sabbah, Arielle , Tagalakis, Vicky , Nanchal, Rahul , Bahadur, Nadia , Belenkaya, Rimma , Nambiar, Puja H. , Papadopoulos, Esperanza B. , Rosenberg, Jonathan E, Cerrone, Kim, Dill, Jennifer A. , Faller, Bryan A. , Alomar, Mohammed , Hume, Emma C, Islam, Jessica Y. , Ajmera, Archana , Brouha, Sharon S. , Choi, Sharon , Jiang, Jun Yang , Kligerman, Seth , Park, Ji, Bhatt, Padmanabh , Mariano, Melissa G., Thomson, Carey C. , Glace, Mary Grace, Knoble, Jeanna, Zacks, Rosemary, Blau, Sibel , Brown, CarrieAnn, Cantrell, Angela Shaw, Namburi, Swathi, Polimera, Hyma , Rovito, Marc A., Edwin, Natasha, Herz, Katrina, Kennecke, Hagen F. , Monfared, Amelia, Sautter, Rachel R, Cronin, Tara, Elshoury, Amro, Fleissner, Bridget, Hernandez‐Ilizaliturri, Francisco J. , Kariapper, Ariffa, Levine, Ellis , Wicher, Camille P., Misdary, Christian, Shah, Mansi , Batist, Gerald , Cook, Erin , Ferrario, Cristiano , Lau, Susie , Rudski, Lawrence , Dutra, Míriam Santos , Mahmood, Sana , Mico, Vasil, Dixon, Becky, Logan, Barbara, Mandapakala, Chaitanya, Cabebe, Elwyn C., Jha, Alokkumar , Schapira, Lidia , Lopes, Gilberto , Cardenas, Karen de, Russell, Karen , Stith, Brittany, Taylor, Sharona, Klamerus, Justin F., Revankar, Sanjay G. , Addison, Daniel , 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JAMA Oncology | November 3, 2022 | Volume: 9 | Issue: 1 | Pages: 128
ImportanceCytokine storm due to COVID-19 can cause high morbidity and mortality and may be more common in patients with cancer treated with immunotherapy (IO) due to immune system activation.ObjectiveTo determine the association of baseline immunosuppression and/or IO-based therapies with COVID-19 severity and cytokine storm in patients with cancer.Design, Setting, and ParticipantsThis registry-based retrospective cohort study included 12 046 patients reported to the COVID-19 and Cancer Consortium (CCC19) registry from March 2020 to May 2022. The CCC19 registry is a centralized international multi-institutional registry of patients with COVID-19 with a current or past diagnosis of cancer. Records analyzed included patients with active or previous cancer who had a laboratory-confirmed infection with SARS-CoV-2 by polymerase chain reaction and/or serologic findings.ExposuresImmunosuppression due to therapy; systemic anticancer therapy (IO or non-IO).Main Outcomes and MeasuresThe primary outcome was a 5-level ordinal scale of COVID-19 severity: no complications; hospitalized without requiring oxygen; hospitalized and required oxygen; intensive care unit admission and/or mechanical ventilation; death. The secondary outcome was the occurrence of cytokine storm.ResultsThe median age of the entire cohort was 65 years (interquartile range [IQR], 54-74) years and 6359 patients were female (52.8%) and 6598 (54.8%) were non-Hispanic White. A total of 599 (5.0%) patients received IO, whereas 4327 (35.9%) received non-IO systemic anticancer therapies, and 7120 (59.1%) did not receive any antineoplastic regimen within 3 months prior to COVID-19 diagnosis. Although no difference in COVID-19 severity and cytokine storm was found in the IO group compared with the untreated group in the total cohort (adjusted odds ratio [aOR], 0.80; 95% CI, 0.56-1.13, and aOR, 0.89; 95% CI, 0.41-1.93, respectively), patients with baseline immunosuppression treated with IO (vs untreated) had worse COVID-19 severity and cytokine storm (aOR, 3.33; 95% CI, 1.38-8.01, and aOR, 4.41; 95% CI, 1.71-11.38, respectively). Patients with immunosuppression receiving non-IO therapies (vs untreated) also had worse COVID-19 severity (aOR, 1.79; 95% CI, 1.36-2.35) and cytokine storm (aOR, 2.32; 95% CI, 1.42-3.79).Conclusions and RelevanceThis cohort study found that in patients with cancer and COVID-19, administration of systemic anticancer therapies, especially IO, in the context of baseline immunosuppression was associated with severe clinical outcomes and the development of cytokine storm.Trial RegistrationClinicalTrials.gov Identifier: NCT04354701