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澳大利亚和新西兰共识立场声明:血液恶性肿瘤患者 COVID-19 治疗药物的使用。

Australia and New Zealand consensus position statement: use of COVID-19 therapeutics in patients with haematological malignancies.

机构信息

Department of Haematology, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia.

School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia.

出版信息

Intern Med J. 2024 Feb;54(2):328-336. doi: 10.1111/imj.16303. Epub 2023 Dec 25.

Abstract

Despite widespread vaccination rates, we are living with high transmission rates of SARS-CoV-2. Although overall hospitalisation rates are falling, the risk of serious infection remains high for patients who are immunocompromised because of haematological malignancies. In light of the ongoing pandemic and the development of multiple agents for treatment, representatives from the Haematology Society of Australia and New Zealand and infectious diseases specialists have collaborated on this consensus position statement regarding COVID-19 management in patients with haematological disorders. It is our recommendation that both patients with haematological malignancies and treating specialists be educated regarding the preventive and treatment options available and that patients continue to receive adequate vaccinations, keeping in mind the suboptimal vaccine responses that occur in haematology patients, in particular, those with B-cell malignancies and on B-cell-targeting or depleting therapy. Patients with haematological malignancies should receive treatment for COVID-19 in accordance with the severity of their symptoms, but even mild infections should prompt early treatment with antiviral agents. The issue of de-isolation following COVID-19 infection and optimal time to treatment for haematological malignancies is discussed but remains an area with evolving data. This position statement is to be used in conjunction with advice from infectious disease, respiratory and intensive care specialists, and current guidelines from the National COVID-19 Clinical Evidence Taskforce and the New Zealand Ministry of Health and Cancer Agency Te Aho o Te Kahu COVID-19 Guidelines.

摘要

尽管疫苗接种率广泛,但我们仍面临着 SARS-CoV-2 的高传播率。尽管总体住院率正在下降,但由于血液恶性肿瘤而免疫功能低下的患者仍然存在严重感染的高风险。鉴于持续的大流行和多种治疗药物的开发,澳大利亚和新西兰血液学会的代表以及传染病专家合作制定了这份关于血液系统疾病患者 COVID-19 管理的共识立场声明。我们建议教育血液恶性肿瘤患者及其治疗专家有关可用的预防和治疗选择,并建议患者继续接受充分的疫苗接种,同时牢记血液系统患者(特别是 B 细胞恶性肿瘤和 B 细胞靶向或耗竭治疗患者)中疫苗反应不佳的情况。血液恶性肿瘤患者应根据其症状的严重程度接受 COVID-19 的治疗,但即使是轻度感染也应及早使用抗病毒药物进行治疗。感染 COVID-19 后的解除隔离和血液恶性肿瘤最佳治疗时间的问题已进行讨论,但仍然是一个数据不断发展的领域。本立场声明与传染病、呼吸和重症监护专家的建议以及国家 COVID-19 临床证据工作组和新西兰卫生部和癌症机构 Te Aho o Te Kahu COVID-19 指南的当前指南一起使用。

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