血液恶性瘤患者的持久性COVID-19:在奥米克朗时代的专注审查
Hajime Yasuda1, Jun Ando2, Miki Ando1
1Department of Hematology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Clinical lymphoma, myeloma & leukemia
|December 27, 2025
概括
血液性恶性瘤患者面临高的COVID-19死亡率和持续的COVID-19 (pCOVID-19). 本综述提供了关于管理pCOVID-19的实际指导,包括风险因素和抗病毒治疗,以帮助临床医生.
科学领域:
- 血液学 血液学 血液学
- 传染性疾病 传染性疾病
- 在瘤学瘤学.
背景情况:
- COVID-19对患有血液性恶性瘤 (HM) 的患者构成重大威胁,死亡率高,患有持续性COVID-19 (pCOVID-19) 的风险高.
- pCOVID-19可能危及生命,破坏必要的化疗,构成传染风险,并导致SARS-CoV-2多药耐药突变的出现.
- 由于随机临床试验的证据有限,在HM患者中缺乏pCOVID-19的最佳管理策略.
研究的目的:
- 在HM患者中对Omicron pCOVID-19进行全面的文献审查.
- 收集现有证据,并为临床医生在这个脆弱人群中管理pCOVID-19提供实际建议.
- 解决pCOVID-19管理的关键方面,包括风险因素,治疗选择和监测.
主要方法:
- 进行了一项综合性文献综述,重点关注血液恶性瘤患者的Omicron变体pCOVID-19.
- 从案例报告和小案例系列中收集和分析了分散的证据.
- 关键主题如疫苗的有效性,风险因素,治疗方法和监测策略被综合起来.
主要成果:
- 在HM患者中发现了pCOVID-19的风险因素,包括B细胞耗尽剂,bendamustine + rituximab和双特异性T细胞参与剂.
- 审查了pCOVID-19的治疗策略,包括扩展,序列和抗病毒药物 (nirmatrelvir/ritonavir,remdesivir,molnupiravir,ensitrelvir) 和免疫疗法 (康复性血,IVIG) 的联合疗法.
- 讨论了使用逆转录 (RT) -PCR和最佳目标周期值的pCOVID-19监测.
结论:
- 对于血液性恶性瘤患者来说,pCOVID-19 带来了独特的挑战,影响了他们的潜在疾病和治疗.
- 基于证据的建议,管理pCOVID-19在HM患者的临床实践至关重要.
- 需要进行进一步的研究,以在这种免疫受损人群中建立pCOVID-19的最终管理准则.
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