慢性骨髓性白血病的管理与COVID-19和乙型肝炎
Tian Yu1,2, Weiming Li3, Tao Yu1
1Department of Hematology, Affiliated Renhe Hospital of China Three Gorges University, Yichang, China.
Frontiers in oncology
|August 21, 2023
概括
氨酸激酶抑制剂 (TKI) 改善慢性髓性白血病 (CML) 治疗,但增加了诸如乙型肝炎和COVID-19等感染的风险. 本综述概述了患有这些并发性疾病的CML患者的管理策略,以改善结果.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 传染性疾病 传染性疾病
背景情况:
- 氨酸激酶抑制剂 (TKI) 已经改变了慢性髓性白血病 (CML) 的治疗方法,改善了患者的预后.
- 然而,TKI的使用与感染性并发病的风险增加有关,特别是乙型肝炎和COVID-19,由于免疫功能抑制.
- 传染病管理对于预防CML治疗中断和不良临床结果至关重要.
研究的目的:
- 为患有并发性乙型肝炎或COVID-19的CML患者提供病变发生和标准化管理原则的概述.
- 提高临床医生对CML患者这些感染相关的风险的认识.
- 改善CML患者的诊断,治疗,生存率和生活质量.
主要方法:
- 对CML中TKI治疗现有文献的综述.
- 分析与TKI相关的免疫抑制的发病性.
- 对CML患者与乙型肝炎和COVID-19共感染的临床数据的检查.
主要成果:
- TKI治疗可以抑制免疫功能,增加对感染的易感性.
- 乙型肝炎的重新激活和SARS-CoV-2感染存在重大风险,可能导致肝功能衰竭或CML进展.
- 建议对CML患者进行SARS-CoV-2疫苗接种,目前还在讨论是否停止TKI治疗.
结论:
- 对于接受TKI治疗的CML患者来说,B型肝炎和COVID-19并发症的有效管理至关重要.
- 管理这些感染的标准化方案是必要的,包括预防性抗病毒疗法和药物选择.
- 解决这些并发症可以减轻不良后果,并改善患者的整体生存率和生活质量.
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