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新型冠状病毒肺炎对急性白血病患者临床特征及预后的影响:一家学术中心的经验

Impact of COVID-19 on the Clinical Characteristics and Outcomes of Patients with Acute Leukaemia: An academic centre experience.

作者信息

Al-Kindi Al-Yaqadhan, Al-Busaidi Thuraya, Al-Kindi Yahya, Al-Bulushi Fatma, Al-Hanini Mohamed, Al-Bakri Maryam, Al-Khabori Murtadha

机构信息

College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.

Department of Hematology, Sultan Qaboos University Hospital, University Medical City, Muscat, Oman.

出版信息

Sultan Qaboos Univ Med J. 2024 Nov;24(4):568-574. doi: 10.18295/squmj.11.2024.078. Epub 2024 Nov 27.

Abstract

OBJECTIVES

This study aimed to identify the impact of the COVID-19 pandemic on the frequency, clinical characteristics and outcomes of patients with acute myeloid leukaemia (AML) and acute lymphoblastic leukaemia (ALL).

METHODS

This retrospective cohort study included all patients treated at Sultan Qaboos University Hospital in Muscat, Oman with AML or ALL from January 2017 to December 2021. Data were obtained from the electronic medical record, and patients diagnosed before the start of the COVID-19 pandemic were compared with those diagnosed during the pandemic using appropriate statistical tests.

RESULTS

A total of 151 patients with ALL (n = 58) and AML (n = 93) were included, of whom 78 were diagnosed before the COVID-19 pandemic and 73 during the pandemic. The rate of acute leukaemia increased during the pandemic ( = 0.039). The clinical characteristics and molecular profiles were similar between the 2 periods, except for platelet count which was higher during the pandemic compared to before the pandemic (median platelet count: 55 × 10/L versus 47 × 10/L; = 0.02). No significant difference was found in the number of FLT3-positive AML; however, the number of NPM1-mutated AML cases was higher during the pandemic ( = 0.02). The number of Philadelphia-positive ALL cases remained consistent between the 2 time periods. The complete remission ( = 0.48) and the overall survival rates were similar ( >0.05).

CONCLUSION

Except for an increased rate of acute leukaemia and a lower platelet count, the COVID-19 pandemic did not impact the presentation and outcomes of acute leukaemia.

摘要

目的

本研究旨在确定2019冠状病毒病(COVID-19)大流行对急性髓系白血病(AML)和急性淋巴细胞白血病(ALL)患者的发病频率、临床特征及预后的影响。

方法

这项回顾性队列研究纳入了2017年1月至2021年12月在阿曼马斯喀特的苏丹卡布斯大学医院接受治疗的所有AML或ALL患者。数据从电子病历中获取,使用适当的统计检验方法,将在COVID-19大流行开始前确诊的患者与大流行期间确诊的患者进行比较。

结果

共纳入151例ALL患者(n = 58)和AML患者(n = 93),其中78例在COVID-19大流行前确诊,73例在大流行期间确诊。大流行期间急性白血病发病率有所上升(P = 0.039)。两个时期的临床特征和分子谱相似,但大流行期间的血小板计数高于大流行前(血小板计数中位数:55×10⁹/L对47×10⁹/L;P = 0.02)。FLT3阳性AML的数量无显著差异;然而,大流行期间NPM1突变AML病例的数量更高(P = 0.02)。两个时间段费城染色体阳性ALL病例的数量保持一致。完全缓解率(P = 0.48)和总生存率相似(P>0.05)。

结论

除急性白血病发病率上升和血小板计数降低外,COVID-19大流行并未影响急性白血病的临床表现和预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5e8/11614021/587783b05386/squmj2411-568-574f1.jpg

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