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血液系统恶性肿瘤合并 COVID-19 患者的结局:来自 ASH 研究协作数据中心的报告。

Outcomes of patients with hematologic malignancies and COVID-19: a report from the ASH Research Collaborative Data Hub.

机构信息

Division of Hematology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.

Department of Data Science, Dana-Farber Cancer Institute, Boston, MA.

出版信息

Blood Adv. 2020 Dec 8;4(23):5966-5975. doi: 10.1182/bloodadvances.2020003170.

Abstract

Coronavirus disease 2019 (COVID-19) is an illness resulting from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that emerged in late 2019. Patients with cancer, and especially those with hematologic malignancies, may be at especially high risk of adverse outcomes, including mortality resulting from COVID-19 infection. The ASH Research Collaborative COVID-19 Registry for Hematology was developed to study features and outcomes of COVID-19 infection in patients with underlying blood disorders, such as hematologic malignancies. At the time of this report, data from 250 patients with blood cancers from 74 sites around the world had been entered into the registry. The most commonly represented malignancies were acute leukemia (33%), non-Hodgkin lymphoma (27%), and myeloma or amyloidosis (16%). Patients presented with a myriad of symptoms, most frequently fever (73%), cough (67%), dyspnea (50%), and fatigue (40%). Use of COVID-19-directed therapies, such as hydroxychloroquine (n = 76) or azithromycin (n = 59), was common. Overall mortality was 28%. Patients with a physician-estimated prognosis from the underlying hematologic malignancy of <12 months at the time of COVID-19 diagnosis and those with relapsed/refractory disease experienced a higher proportion of moderate/severe COVID-19 disease and death. In some instances, death occurred after a decision was made to forgo intensive care unit admission in favor of a palliative approach. Taken together, these data support the emerging consensus that patients with hematologic malignancies experience significant morbidity and mortality resulting from COVID-19 infection. Batch submissions from sites with high incidence of COVID-19 infection are planned to support future analyses.

摘要

新型冠状病毒病 2019(COVID-19)是一种由严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)引起的疾病,于 2019 年末出现。癌症患者,尤其是血液系统恶性肿瘤患者,可能面临极高的不良结局风险,包括 COVID-19 感染导致的死亡率。ASh 研究协作 COVID-19 血液学登记研究旨在研究基础血液疾病(如血液系统恶性肿瘤)患者 COVID-19 感染的特征和结局。截至本报告发布时,该登记研究已纳入来自全球 74 个地点的 250 名血液癌患者的数据。最常见的恶性肿瘤是急性白血病(33%)、非霍奇金淋巴瘤(27%)和骨髓瘤或淀粉样变性(16%)。患者表现出多种症状,最常见的是发热(73%)、咳嗽(67%)、呼吸困难(50%)和疲劳(40%)。COVID-19 定向治疗的应用较为常见,如羟氯喹(n = 76)或阿奇霉素(n = 59)。总体死亡率为 28%。COVID-19 诊断时基础血液恶性肿瘤医生估计预后<12 个月的患者以及复发/难治性疾病患者经历中度/重度 COVID-19 疾病和死亡的比例更高。在某些情况下,在决定放弃重症监护病房入院并采用姑息治疗方法后,患者死亡。综上所述,这些数据支持了一种新的共识,即血液系统恶性肿瘤患者因 COVID-19 感染而遭受严重的发病率和死亡率。计划从 COVID-19 感染发生率较高的地点批量提交数据,以支持未来的分析。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3be8/7724912/88bf9fa571a8/advancesADV2020003170absf1.jpg

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