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COVID-19 对淀粉样变和免疫球蛋白沉积病管理的影响:单中心经验。

The impact of COVID-19 in the management of AL amyloidosis and Immunoglobulin Deposition Disease: A single-center experience.

机构信息

Department of Medical Oncology and Hematology, Tom Baker Cancer Center, Calgary, AB, Canada.

Charbonneau Cancer Research Institute, Calgary, AB, Canada.

出版信息

Eur J Haematol. 2021 Mar;106(3):340-345. doi: 10.1111/ejh.13552. Epub 2020 Nov 29.

Abstract

INTRODUCTION

Patients with AL amyloidosis and immunoglobulin deposition diseases (IDD) are vulnerable during the COVID-19 pandemic due to the immune compromise from the plasma cell disorder and therapy-related immune defects. We describe a local experience in providing care for patients with AL amyloidosis and IDD.

METHOD

Patient treatment and disease status since the beginning of the pandemic on March 11, 2020, as declared by WHO, were collected and analyzed.

RESULTS

Ninety-six patients with AL amyloidosis and IDD were included. Four patients with IDD and 22 patients with systemic AL amyloidosis were receiving treatment during the pandemic. Since the pandemic, patients' treatments were discontinued if they achieved VGPR or better postinduction. Seven patients discontinued all treatment after achieving VGPR, and others required treatment modifications. 28 patients have been tested for COVID-19, and all tests have been negative. Three patients died since the pandemic, two from organ complications of systemic AL amyloidosis and one from an unrelated cause.

CONCLUSION

The management of AL amyloidosis and IDD must be individualized on the clinical characteristics, centers' access to care under the pandemic restrictions, and the epidemiological aspects of the outbreak.

摘要

简介

由于浆细胞疾病导致的免疫缺陷和治疗相关的免疫缺陷,患有 AL 淀粉样变性和免疫球蛋白沉积病(IDD)的患者在 COVID-19 大流行期间易感染。我们描述了在提供 AL 淀粉样变性和 IDD 患者护理方面的本地经验。

方法

自 2020 年 3 月 11 日世界卫生组织宣布 COVID-19 大流行开始以来,收集并分析了患者的治疗和疾病状况。

结果

共纳入 96 例 AL 淀粉样变性和 IDD 患者。4 例 IDD 患者和 22 例系统性 AL 淀粉样变性患者在大流行期间接受治疗。自大流行以来,如果患者在诱导后达到非常好的部分缓解或更好的缓解,则停止治疗。7 名患者在达到非常好的部分缓解后停止了所有治疗,而其他患者需要进行治疗调整。28 例患者接受了 COVID-19 检测,所有检测均为阴性。自大流行以来,有 3 名患者死亡,其中 2 例死于系统性 AL 淀粉样变性的器官并发症,1 例死于非相关原因。

结论

AL 淀粉样变性和 IDD 的管理必须根据临床特征、中心在大流行限制下获得护理的机会以及疫情的流行病学方面进行个体化。

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