Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Huazhong University of Science and Technology Union Shenzhen Hospital, Guangdong Medical University, Shenzhen, Guangdong, China.
Leukemia. 2020 Jul;34(7):1799-1804. doi: 10.1038/s41375-020-0853-6. Epub 2020 May 18.
We studied by questionnaire 530 subjects with chronic myeloid leukaemia (CML) in Hubei Province during the recent SARS-CoV-2 epidemic. Five developed confirmed (N = 4) or probable COVID-19 (N = 1). Prevalence of COVID-19 in our subjects, 0.9% (95% Confidence Interval, 0.1, 1.8%) was ninefold higher than 0.1% (0, 0.12%) reported in normals but lower than 10% (6, 17%) reported in hospitalised persons with other haematological cancers or normal health-care providers, 7% (4, 12%). Co-variates associated with an increased risk of developing COVID-19 amongst persons with CML were exposure to someone infected with SARS-CoV-2 (P = 0.037), no complete haematologic response (P = 0.003) and co-morbidity(ies) (P = 0.024). There was also an increased risk of developing COVID-19 in subjects in advanced phase CML (P = 0.004) even when they achieved a complete cytogenetic response or major molecular response at the time of exposure to SARS-CoV-2. 1 of 21 subjects receiving 3rd generation tyrosine kinase-inhibitor (TKI) developed COVID-19 versus 3 of 346 subjects receiving imatinib versus 0 of 162 subjects receiving 2nd generation TKIs (P = 0.096). Other co-variates such as age and TKI-therapy duration were not significantly associated with an increased risk of developing COVID-19. Persons with these risk factors may benefit from increased surveillance of SARS-CoV-2 infection and possible protective isolation.
我们在 SARS-CoV-2 疫情期间通过问卷调查研究了湖北省 530 例慢性髓性白血病 (CML) 患者。其中 5 例确诊 (N=4) 或可能 COVID-19 (N=1)。我们研究对象的 COVID-19 患病率为 0.9%(95%置信区间，0.1，1.8%)，是正常人群中 0.1%(0，0.12%)的九倍，但低于住院的其他血液系统癌症患者或正常医护人员中报告的 10%(6，17%)，高于报告的 7%(4，12%)。在 CML 患者中，与 COVID-19 风险增加相关的协变量包括接触 SARS-CoV-2 感染者 (P=0.037)、未完全血液学反应 (P=0.003) 和合并症 (P=0.024)。在 CML 晚期患者中，发生 COVID-19 的风险也增加 (P=0.004)，即使他们在接触 SARS-CoV-2 时达到完全细胞遗传学反应或主要分子反应。在接受第三代酪氨酸激酶抑制剂 (TKI) 的 21 名患者中，有 1 名发生 COVID-19，而在接受伊马替尼的 346 名患者中，有 3 名发生 COVID-19，在接受第二代 TKI 的 162 名患者中，有 0 名发生 COVID-19(P=0.096)。其他协变量，如年龄和 TKI 治疗持续时间，与 COVID-19 风险增加没有显著相关性。具有这些危险因素的患者可能受益于加强 SARS-CoV-2 感染监测和可能的保护性隔离。
