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一项关于 SARS-CoV-2 感染在 CML 患者中的单中心研究:疫苗接种状况和博舒替尼治疗可能是住院的保护因素。

Single-center study on SARS-CoV-2 infection in patients affected by CML: Vaccination status and bosutinib therapy as possible protective factors for hospitalization.

机构信息

Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.

Hematology Division, San Gerardo Hospital, ASST Monza, Monza, Italy.

出版信息

Cancer Med. 2023 Apr;12(8):9662-9667. doi: 10.1002/cam4.5923. Epub 2023 Apr 11.

Abstract

INTRODUCTION

COVID-19 pandemic had a considerable impact among haematological patients. On the other hand, the effect of this disease on patients (pts) affected by Chronic Myeloid Leukemia (CML) is not clearly defined.

OBJECTIVES

The primary objective of this study was to evaluate mortality-hospitalization rates and possible protective factors for hospitalization in CML pts affected by COVID.

METHODS

We collected data from CML patients followed at our institution whotested positive for SARS-CoV-2 infection. The following variables were assessed: demographical data, type of TKI therapy, vaccination status, presence of cardiovascular disease (CVD), period of infection, COVID-19 presenting symptoms, severity and mortality. Data were collected retrospectively and then analysed in univariate and multivariate analysis.

RESULTS

Out of a total of 325 CML pts treated at our institution, we recorded 72 SARS-CoV-2pts (22%) who tested positive with a SARS-CoV-2 PCR assay. Twenty two were infected in 2020 (30%), 16 patients in 2021 (22%) and 34 in 2022 (46%); with a hospitalization rate of 27%, 25% and 3% respectively. Of the 72 confirmed infections, 13 pts (18%; (CI) 10-28) were asymptomatic and 48 (66%; CI: 55-76) had mild symptoms. A total of 11 pts were admitted to hospital and 3 of these required ICU admission. No deaths were recorded. The probability of hospitalization was significantly reduced if patients were vaccinated (odds ratio OR 0.037 with CI: 0-0.33 p 0.002) or treated with Bosutinib (OR 0.06 with CI: 0-0.5 p 0.008).

CONCLUSION

In the present study, no significant increase in mortality was noted among patients with CML as compared to the general population inItaly. Vaccination and treatment with bosutinib were identified as baseline characteristics that were associated with a decreased risk of hospitalitazion resulting from COVID-19 infection.

摘要

简介

COVID-19 大流行对血液系统疾病患者产生了重大影响。另一方面,这种疾病对慢性髓性白血病 (CML) 患者的影响尚不清楚。

目的

本研究的主要目的是评估 COVID 感染的 CML 患者的死亡率-住院率和可能的住院保护因素。

方法

我们收集了在我们机构接受 SARS-CoV-2 感染检测呈阳性的 CML 患者的数据。评估了以下变量:人口统计学数据、TKI 治疗类型、疫苗接种状况、心血管疾病 (CVD) 存在情况、感染期、COVID-19 表现症状、严重程度和死亡率。数据是回顾性收集的,然后进行单变量和多变量分析。

结果

在我们机构接受治疗的总共 325 名 CML 患者中,我们记录了 72 名 SARS-CoV-2 患者(22%),他们的 SARS-CoV-2 PCR 检测呈阳性。22 例发生在 2020 年(30%),16 例发生在 2021 年(22%),34 例发生在 2022 年(46%);住院率分别为 27%、25%和 3%。在 72 例确诊感染中,13 例(18%;CI:10-28)无症状,48 例(66%;CI:55-76)有轻度症状。共有 11 名患者住院,其中 3 名需要 ICU 入院。没有死亡记录。如果患者接种疫苗(比值比 OR 0.037,CI:0-0.33,p<0.002)或接受 Bosutinib 治疗(OR 0.06,CI:0-0.5,p<0.008),则住院的可能性显著降低。

结论

在本研究中,与意大利普通人群相比,CML 患者的死亡率没有明显增加。接种疫苗和接受 Bosutinib 治疗被确定为与 COVID-19 感染导致的住院风险降低相关的基线特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0040/10166942/0b5e8da36b08/CAM4-12-9662-g001.jpg

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