Abstract P006

Clinical outcome of classical Hodgkin Lymphoma patients receiving systemic anti-lymphoma treatment during SARS-COV-2 positivity: Results from the chemo-covid study on behalf of fondazione italiana linfomi

Patients (pts) affected by classical Hodgkin Lymphoma (cHL) infected by SARS-CoV-2 are at risk of protracted positivity due to immunodeficiency, and consequent delay of anti-lymphoma treatment may worsen cHL prognosis. Feasibility of chemo-therapy (CT) administration during SARS-CoV-2 infection in cHL pts has not been investigated so far. We collected data of cHL pts enrolled in Haematocovid observational trial and treated with CT while positive for SARS-CoV-2, with the aim to describe CT feasibility and to assess the risk of infection worsening. Thirteen cHL pts treated since May 2020 to May 2022 were included: median age was 39 years (17-68), 6 pts (46%) presented with advanced stage, 8 pts (62%) with B symptoms and 5 pts (38%) with bulky. Seven pts (54%) were treatment-naïve and waiting for ABVD start at time of COVID diagnosis, while in 6 pre-treated pts (46%) SARS-CoV-2 infection occurred after a median time of 18 days (1-42) from administration of the last CT cycle and the median number of prior therapeutic lines was 1 (1-4). Eight pts (62%) previously received m-RNA vaccines, while 5 pts (38%) were infected in the pre-vaccine era. At COVID onset, 6 (46%) pts were asymptomatic and 7 (54%) pauci-symptomatic, being fever (n=5) the most reported symptom; pneumonia was documented in 2 pts, but no case of respiratory failure was described. Viral variant was identified in 7 pts: 1 alpha, 1 delta and 5 omicron, while in 6 pts the presumed variant was derived from pandemic wave (3 pts alpha, 1 pt delta and 3 pts omicron). Four pts (31%) received antiviral treatment, consisting in monoclonal antibodies (n=3) and remdesivir (n=1). A median of 1 cycle of CT (1-2) after a median time of 25 days (1-45) from the first SARS-CoV-2 positivity was delivered. Ten pts (77%) received ABVD, in two cases with bleomycine omission, 1 pt (8%) received escBEACOPP and 2 pts (15%) brentuximab-vedotin. None of the pts experienced COVID worsening following CT administration. Median duration of SARS-CoV-2 positivity was 21 days (9-60). After a median follow-up of 11 months (1-61), one pt died due to cHL progressive disease while positive but asymptomatic for SARS-CoV-2. All the remaining pts were alive and negative for SARS-CoV-2 infection, and 8 pts (62%) achieved cHL complete response. In conclusion, in this preliminary analysis CT administration to high-risk cHL pts positive but asymptomatic for SARS-CoV-2 seems feasible and did not induce clinical worsening of viral infection.


Chiara Rusconi, Benedetta Puccini, Carlo Visco, Francesca Ricci, Alessandro Re, Vittorio R. Zilioli, Caterina Zerbi, Stefan Hohaus, Federico Mazzon, Manuel Ciceri, Anna Guidetti, Vincenzo Marasco, Luigi Rigacci