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