潘玲.成人恶性血液病患者感染omicron突变株的防治策略[J].内科急危重症杂志,2023,29(2):89-95
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| DOI：10.11768/nkjwzzzz20230201 |
| 中文关键词: 新型冠状病毒 omicron突变株 恶性血液病 防治措施 |
| 英文关键词: |
| 基金项目:天津市科技计划项目（No:21JCZDJC01170）；中国医学科学院医学与健康科技创新工程项目（2021-I2M-C&T-B-080；2021-I2M-1-017）；细胞生态海河实验室创新基金（No:22HHXBSS00036） |
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| 中文摘要: |
| 恶性血液病（HM）患者在omicron时期的感染率和死亡率高于其它人群。血液病疾病进展状态、高龄、基础病、造血干细胞移植（HSCT）和嵌合抗原受体T细胞治疗等均与HM新冠病毒感染患者的预后密切相关，而系统性抗肿瘤治疗（SACT）对患者的预后影响较小，建议在权衡患者血液病状态及新冠病毒感染严重程度的情况下决定是否延迟治疗或更换治疗方案。在预防新冠病毒感染方面，接种疫苗及加强针、加强个人防护是降低感染率和死亡率的重要方式，必要时可以注射Evusheld以增强抗感染能力。在治疗方面常采用抗病毒结合免疫调节的方式，但抗S单抗、激酶抑制剂、抗IL-6单抗、粒细胞集落刺激因子（G-CSF)、抗凝药等药物在HM患者中的有效性和安全性还需进一步评估。 |
| 英文摘要: |
| Patients with hematological malignancies (HM) have higher infection and mortality rates during the omicron period than other populations. HM progression, advanced age, comorbidities, hematopoietic stem cell transplantation (HSCT), and chimeric antigen receptor T-cell (CAR-T)therapy are all closely associated with the prognosis of HM patients infected with omicron variant, while systemic anti-cancer therapy (SACT) has a smaller impact on patient outcomes. Therefore, it is recommended to weigh the patient's hematological status and the severity of SARS-CoV-2 infection when deciding whether to delay or change treatment plans. Full vaccination and enhanced personal protective measures are important ways to prevent infection and improve outcomes. If necessary, Evusheld can be administered to enhance the anti-infection ability. In terms of treatment, a combination of antiviral therapy and immune modulation is often used, but the efficacy and safety of drugs such as anti-spike monoclonal antibodies, kinase inhibitors, IL-6 antagonists, granulocyte colony-stimulating factor, and anticoagulants in HM patients still need to be further evaluated. |
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