Challenges in the Clinical Management of {SARS}-{CoV}2-Infected Patients with Haematological Malignancies

During the SARS-CoV-2 pandemic, it has been rapidly clear that patients suffering from haematological malignancies seem to present a more severe infection, higher mortality, prolonged viral shedding and worst outcome compared to general population. We described two cases of COVID-19 related pneumonia in hematological patients hospitalized on January at an academic hospital in Rome. The two patients had both an active haematological disease with a recent chemotherapeutic treatment and received two doses of anti-SARS-CoV-2 vaccine without seroconversion. However, they underwent an initial improvement followed by a rapid deterioration of general condition, despite the prompt and numerous therapies administered. COVID-19 patients with haematological malignancies have a mortality rate threefold–fourfold higher than general population. In haematological patients, it has been reported a heterogenous antibody responses to vaccination with an overall low seroconversion rate. We wondered whether other strategies could have changed the outcome of these patients. Despite the therapeutic advances to fight the COVID-19 pandemic, patients with haematological malignancies remain a population with high mortality risk. Non-pharmacological interventions while SARS-CoV-2 is circulating in the community are still important, but prospective studies to develop optimal vaccination strategies as well as novel pharmacological tools for these patients are warranted.