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慢性髓性白血病患者中 SARS-CoV-2 感染的血清流行率与一般人群相似。

The serological prevalence of SARS-CoV-2 infection in patients with chronic myeloid leukemia is similar to that in the general population.

机构信息

Department of Medicine, Section of Hematology, University of Verona, Verona, Italy.

Division of Hematology and BMT, Department of Medical Area, University of Udine, Udine, Italy.

出版信息

Cancer Med. 2021 Sep;10(18):6310-6316. doi: 10.1002/cam4.4179. Epub 2021 Aug 31.

Abstract

BACKGROUND

Patients with hematological malignancies are at an increased risk of SARS-CoV-2 disease (COVID-19) and adverse outcome. However, a low mortality rate has been reported in patients with chronic myeloid leukemia (CML). Preclinical evidence suggests that tyrosine kinase inhibitors (TKIs) may have a protective role against severe COVID-19.

METHODS

We conducted a cross-sectional study of 564 consecutive patients with CML who were tested for anti-SARS-CoV-2 IgG/IgM antibodies at their first outpatient visit between May and early November 2020 in five hematologic centers representative of three Italian regions.

RESULTS

The estimated serological prevalence of SARS-CoV-2 infection in patients with CML after the first pandemic wave was similar to that in the general population (about 2%), both at national and regional levels. CML patients with positive anti-SARS-CoV-2 serology were more frequently male (p = 0.027) and active workers (p = 0.012), while there was no significant association with TKI treatment type. Only 3 out of 11 IgG-positive patients had previously received a molecular diagnosis of COVID-19, while the remainders were asymptomatic or with mild symptoms.

CONCLUSIONS

Our data confirm that the course of SARS-CoV-2 infection in patients with CML is generally mild and reassure about the safety of continuing TKIs during the COVID-19 pandemic. Furthermore, we suggest that patients with CML succeed to mount an antibody response after exposure to SARS-CoV-2, similar to the general population.

摘要

背景

血液系统恶性肿瘤患者感染严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2,即新冠病毒)的风险增加,且结局不良。然而,有报道显示慢性髓性白血病(CML)患者的死亡率较低。临床前证据表明,酪氨酸激酶抑制剂(TKI)可能对严重的新冠病毒病(COVID-19)具有保护作用。

方法

我们对 564 例连续 CML 患者进行了横断面研究,这些患者于 2020 年 5 月至 11 月初首次门诊就诊时,在代表意大利三个地区的五个血液学中心接受了 SARS-CoV-2 IgG/IgM 抗体检测。

结果

在第一次大流行浪潮之后,CML 患者中 SARS-CoV-2 感染的血清学估计患病率与一般人群相似(约 2%),无论是在全国层面还是在地区层面。抗 SARS-CoV-2 血清学阳性的 CML 患者中,男性(p=0.027)和在职人员(p=0.012)更为常见,而与 TKI 治疗类型无关。11 例 IgG 阳性患者中只有 3 例之前曾接受过 COVID-19 的分子诊断,而其余患者无症状或仅有轻度症状。

结论

我们的数据证实,CML 患者的 SARS-CoV-2 感染过程通常较为轻微,这为在 COVID-19 大流行期间继续使用 TKI 提供了安全性保证。此外,我们建议 CML 患者在接触 SARS-CoV-2 后能够成功产生抗体反应,这与一般人群相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5509/8446554/5342df16c4a9/CAM4-10-6310-g002.jpg

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