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El-Ashwah S, Salmanton-García J, Bilgin YM, Itri F, Žák P, Weinbergerová B, Verga L, Omrani AS, Silva MGD, Szotkowski T, Marchetti M, Buquicchio C, Nucci M, Schönlein M, Farina F, Besson C, Prezioso L, Nizamuddin S, Dávila-Valls J, Martín-Pérez S, Bonuomo V, Van Doesum J, Tisi MC, Passamonti F, Méndez GA, Meers S, Maertens J, López-García A, Glenthøj A, Bonnani M, Rinaldi I, Ormazabal-Vélez I, Labrador J, Kulasekararaj A, Espigado I, Demirkan F, De Jonge N, Collins GP, Calbacho M, Blennow O, Al-Khabori M, Adžić-Vukičević T, Arellano E, Mišković B, Mladenović M, Nordlander A, Ráčil Z, Ammatuna E, Cordoba R, Hersby DS, Gräfe S, Emarah Z, Hanakova M, Sacchi MV, Ijaz M, Rahimli L, Nunes Rodrigues R, Zambrotta GPM, Marchesi F, Cornely OA, Pagano L. The mortality of COVID-19 in CML patients from 2020 until 2022: results from the EPICOVIDEHA survey. Leuk Lymphoma 2024; 65:199-208. [PMID: 37966980 DOI: 10.1080/10428194.2023.2280886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/10/2023] [Indexed: 11/17/2023]
Abstract
Since the beginning of the COVID-19 pandemic, there has been an overall improvement in patient mortality. However, haematological malignancy patients continue to experience significant impacts from COVID-19, including high rates of hospitalization, intensive care unit (ICU) admissions, and mortality. In comparison to other haematological malignancy patients, individuals with chronic myeloid leukemia (CML) generally have better prognosis. This study, conducted using a large haematological malignancy patient database (EPICOVIDEHA), demonstrated that the majority of CML patients experienced mild infections. The decline in severe and critical infections over the years can largely be attributed to the widespread administration of vaccinations and the positive response they elicited. Notably, the mortality rate among CML patients was low and exhibited a downward trend in subsequent years. Importantly, our analysis provided confirmation of the effectiveness of vaccinations in CML patients.
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Affiliation(s)
| | - Jon Salmanton-García
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, University Hospital Cologne, Institute of Translational Research, Cologne, Germany
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Yavuz M Bilgin
- Department of Internal Medicine, ADRZ, Goes, Netherlands
| | - Federico Itri
- San Luigi Gonzaga Hospital - Orbassano, Orbassano, Italy
| | - Pavel Žák
- University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Barbora Weinbergerová
- Department of Internal Medicine - Hematology and Oncology, Masaryk University Hospital Brno, Brno, Czech Republic
| | - Luisa Verga
- Azienda Ospedaliera San Gerardo - Monza, Monza, Italy
- Università Milano-Bicocca, Milan, Italy
| | - Ali S Omrani
- Communicable Disease Center, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Monia Marchetti
- Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | - Marcio Nucci
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Martin Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Caroline Besson
- Centre Hospitalier de Versailles, Le Chesnay, France
- Université Paris-Saclay, UVSQ, Inserm, Équipe "Exposome et Hérédité", CESP, Villejuif, France
| | - Lucia Prezioso
- Hospital University of Parma - Hematology and Bone Marrow Unit, Parma, Italy
| | | | | | | | - Valentina Bonuomo
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | | | | | - Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | | | | | - Johan Maertens
- Department of Microbiology, Immunology, and Transplantation, KULeuven, Leuven, Belgium
- Department of Hematology, UZ Leuven, Leuven, Belgium
| | - Alberto López-García
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Matteo Bonnani
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | - Ikhwan Rinaldi
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | | | - Jorge Labrador
- Department of Hematology, Research Unit, Hospital Universitario de Burgos, Burgos, Spain
| | | | - Ildefonso Espigado
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | - Fatih Demirkan
- Division of Hematology, Dokuz Eylul University, Izmir, Turkey
| | - Nick De Jonge
- Amsterdam UMC, Location VUmc, Amsterdam, Netherlands
| | - Graham P Collins
- NIHR Oxford Biomedical Research Centre, Churchill Hospital, Oxford, UK
| | | | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | | | - Elena Arellano
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | - Bojana Mišković
- COVID-19 Hospital "Batajnica", Belgrade, Serbia
- Clinic for Orthopedic Surgery and Traumatology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Miloš Mladenović
- COVID-19 Hospital "Batajnica", Belgrade, Serbia
- Clinic for Orthopedic Surgery and Traumatology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Anna Nordlander
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Zdeněk Ráčil
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | | | - Raul Cordoba
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Ditte Stampe Hersby
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Stefanie Gräfe
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, University Hospital Cologne, Institute of Translational Research, Cologne, Germany
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ziad Emarah
- Oncology Center, Mansoura University, Mansoura, Egypt
| | - Michaela Hanakova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Maria Vittoria Sacchi
- Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Marriyam Ijaz
- Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Laman Rahimli
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, University Hospital Cologne, Institute of Translational Research, Cologne, Germany
| | | | | | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Oliver A Cornely
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, University Hospital Cologne, Institute of Translational Research, Cologne, Germany
- Clinical Trials Centre Cologne (ZKS Köln), University of Cologne, University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Faculty of Medicine, and University Hospital Cologne, Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Livio Pagano
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
- Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
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Qi F, Bao M, Gao H, Zhang X, Zhao S, Wang C, Li W, Jiang Q. Patients with chronic myeloid leukemia and coronavirus disease 2019 in the Omicron era. Ann Hematol 2023; 102:2707-2716. [PMID: 37578540 DOI: 10.1007/s00277-023-05413-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/09/2023] [Indexed: 08/15/2023]
Abstract
To explore the prevalence and severity of COVID-19 and the mental health during the Omicron pandemic in patients with chronic myeloid leukemia (CML), a cross-sectional survey from 2609 respondents with CML was performed. A total of 1725 (66%) reported that they had COVID-19 during this period. Among them, 1621 (94%) were mild; 97 (6%), moderate; 7 (0.4%), severe; and 0, critical or death. Four hundred three (15%), 199 (8%), and 532 (20%) had moderate to severe depression, anxiety, and distress, respectively. Eight hundred ninety (34%), 667 (26%), and 573 (22%), avoidance, intrusion, and hyper-arousal, respectively. In multivariate analyses, longer TKI-therapy duration was significantly associated with a lower prevalence of COVID-19 (odds ratio [OR] = 0.98; 95% confidence interval [CI], 0.95, 0.99; p = 0.043); however, living in urban areas (OR = 1.6 [1.3, 2.0]; p < 0.001) and having family members with COVID-19 (OR = 18.6 [15.1, 22.8]; p < 0.001), a higher prevalence of COVID-19. Increasing age (OR = 1.2 [1.1, 1.4]; p = 0.009), comorbidity(ies) (OR = 1.7 [1.1, 2.7]; p = 0.010), and multi-TKI-resistant patients receiving 3rd-generation TKIs or investigational agents (OR = 2.2 [1.2, 4.2]; p = 0.010) were significantly associated with moderate or severe COVID-19. Female, comorbidity(ies), unvaccinated, and moderate or severe COVID-19 were significantly associated with almost all adverse mental health consequences; increasing age or forced TKI dose reduction because of various restriction during the pandemic, moderate to severe distress, avoidance, or intrusion; however, mild COVID-19, none or mild anxiety, distress, avoidance, or intrusion. In conclusion, shorter TKI-therapy duration, increasing age, comorbidity(ies), or multi-TKI-resistant patients receiving 3rd-generation TKIs or investigational agents had a higher prevalence of COVID-19 or higher risk of moderate or severe disease in patients with CML; increasing age, female, comorbidity(ies), forced TKI dose reduction due to the pandemic, moderate or severe COVID-19, unvaccinated, a higher likelihood of worse mental health.
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Affiliation(s)
- Feiyang Qi
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, No. 11 Xizhimen South St, Beijing, 100044, China
| | - Mei Bao
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, No. 11 Xizhimen South St, Beijing, 100044, China
| | - Hanlin Gao
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, No. 11 Xizhimen South St, Beijing, 100044, China
| | - Xiaoshuai Zhang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, No. 11 Xizhimen South St, Beijing, 100044, China
| | - Shasha Zhao
- Peking University People's Hospital, Qingdao, China
| | | | - Wenwen Li
- Peking University People's Hospital, Qingdao, China
| | - Qian Jiang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, No. 11 Xizhimen South St, Beijing, 100044, China.
- Peking University People's Hospital, Qingdao, China.
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.
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Yu T, Li W, Yu T. Management of chronic myelogenous leukemia with COVID-19 and hepatitis B. Front Oncol 2023; 13:1217023. [PMID: 37601670 PMCID: PMC10438954 DOI: 10.3389/fonc.2023.1217023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023] Open
Abstract
The application of immunosuppressive agents and targeted drugs has opened a novel approach for the treatment of hematological tumors, and the application of tyrosine kinase inhibitors for the treatment of chronic myeloid leukemia is one of the landmark breakthroughs that has considerably improved the prognosis of CML patients. However, with the extensive use of TKI, the co-infection of CML patients has become increasingly apparent, especially regarding infectious diseases such as hepatitis B and COVID-19. The underlying mechanism may be related to the inhibition of the immune function by TKI. Poor management, including disease progression due to the infectious disease or TKI dose reduction or discontinuation, may lead to adverse clinical outcomes and can even be life-threatening. Therefore, this review principally provides an overview of the pathogenesis and standardized management principles of CML patients with comorbid COVID-19 or hepatitis B in order to improve clinicians' awareness of the risks so as to more effectively diagnose and treat CML and improve the survival rate and quality of life of patients. In the past two decades, owing to the advent of imatinib, chronic myeloid leukemia (CML) has transformed into a chronic controllable disease, and even treatment-free remission can be anticipated. Earlier studies have indicated that tyrosine kinase inhibitor (TKI) exerts a peculiar inhibitory effect on the body's immune function. Therefore, with the widespread application of TKI, more and more attention has been paid to the comorbidity of infectious diseases in CML patients, especially in patients with progressive disease or non-remission. Despite some studies revealing that the proportion and severity of SARS-CoV-2 infection in CML patients receiving TKI treatment are lower than in patients with other hematological malignancies, CML patients with stable disease are still recommended to be vaccinated against SARS-CoV-2, while TKI may or may not be discontinued. Meanwhile, the management of CML patients during the epidemic of coronavirus disease 2019 (COVID-19) still necessitates further discussion. This article also provides an overview of TKI-related hepatitis B reactivation. If not managed, patients may face adverse consequences such as hepatitis B reactivation-related hepatitis, liver failure, and progression of CML after forced withdrawal of medication. Therefore, this review aimed to comprehensively describe the management of CML patients with comorbid COVID-19, the pathogenesis of hepatitis B reactivation, the indicated population for prophylactic antiviral therapy, the time of antiviral drug discontinuation, and drug selection.
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Affiliation(s)
- Tian Yu
- Department of Hematology, Affiliated Renhe Hospital of China Three Gorges University, Yichang, China
- College of Basic Medical Sciences, China Three Gorges University, Yichang, China
| | - Weiming Li
- Department of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Yu
- Department of Hematology, Affiliated Renhe Hospital of China Three Gorges University, Yichang, China
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Verweij L, Ector GICG, Smit Y, van Vlijmen B, van der Reijden BA, Hermens RPMG, Blijlevens NMA. Effectiveness of digital care platform CMyLife for patients with chronic myeloid leukemia: results of a patient-preference trial. BMC Health Serv Res 2023; 23:228. [PMID: 36890512 PMCID: PMC9994406 DOI: 10.1186/s12913-023-09153-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 02/06/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Two most important factors determining treatment success in chronic myeloid leukemia (CML) are adequate medication compliance and molecular monitoring albeit still being suboptimal. The CMyLife platform is an eHealth innovation, co-created with and for CML patients, aiming to improve their care, leading to an increased quality of life and the opportunity of hospital-free care. OBJECTIVE To explore the effectiveness of CMyLife in terms of information provision, patient empowerment, medication compliance, molecular monitoring, and quality of life. METHODS Effectiveness of CMyLife was explored using a patient-preference trial. Upon completion of the baseline questionnaire, participants actively used (intervention group) or did not actively use (questionnaire group) the CMyLife platform for at least 6 months, after which they completed the post-intervention questionnaire. Scores between the intervention group and the questionnaire group were compared with regard to the within-subject change between baseline and post-measurement using Generalized Estimating Equation models. RESULTS At baseline, 33 patients were enrolled in the questionnaire group and 75 in the intervention group. Online health information knowledge improved significantly when actively using CMyLife and patients felt more empowered. No significant improvements were found regarding medication compliance and molecular monitoring, which were already outstanding. Self-reported effectiveness showed that patients experienced that using CMyLife improved their medication compliance and helped them to oversee their molecular monitoring. Patients using CMyLife reported more symptoms but were better able to manage these. CONCLUSIONS Since hospital-free care has shown to be feasible in time of the COVID-19 pandemic, eHealth-based innovations such as CMyLife could be a solution to maintain the quality of care and make current oncological health care services more sustainable. TRIAL REGISTRATION ClinicalTrials.gov NCT04595955 , 22/10/2020.
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Affiliation(s)
- Lynn Verweij
- Department of Hematology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands.
| | - Geneviève I C G Ector
- Department of Hematology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Yolba Smit
- Department of Hematology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Bas van Vlijmen
- Department of Pharmacy, Radboud University Medical Center, Nijmegen, Netherlands
| | - Bert A van der Reijden
- Department of Laboratory Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Rosella P M G Hermens
- Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Nicole M A Blijlevens
- Department of Hematology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
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Kim CS, Kim JY, Choi DR. COVID-19 pneumonia concurrent with newly diagnosed chronic myelogenous leukemia. Blood Res 2022; 57:74-75. [PMID: 35342044 PMCID: PMC8958368 DOI: 10.5045/br.2022.2021146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/19/2021] [Accepted: 12/24/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Chul Soo Kim
- Hematology and Oncology Service, Department of Internal Medicine, Sahmyook Medical Center, Seoul, Korea
| | - Jeong Yeon Kim
- Infectious Diseases Service, Department of Internal Medicine, Sahmyook Medical Center, Seoul, Korea
| | - Dae Ro Choi
- Hematology and Oncology Service, Department of Internal Medicine, Sahmyook Medical Center, Seoul, Korea
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Rasalkar AA, Bhatia S, Katte T, Narayanan P, Vinjamuri S, Shettihalli AK, Kabade S, Manas RN, Kadappa V, Reddy DNS. COVID-19 and its impact on cancer, HIV, and mentally ill patients. LESSONS FROM COVID-19 2022. [PMCID: PMC9347297 DOI: 10.1016/b978-0-323-99878-9.00006-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) and its disease, COVID-19 is a global pandemic creating an unprecedented medical as well economic havoc across the world. Despite the wide spread global infection rates, the death rate is low for COVID-19. However, COVID-19 patients with other comorbid conditions face severe health complications irrespective of their gender or age. As the management of COVID-19 patients is taking up health resources, it is getting difficult to treat patients suffering from other dreadful diseases like cancer, HIV, and mental health issues. In this chapter, we discuss the effects of COVID-19 and management of cancer patients of main cancer subtypes (e.g., breast, lung, blood cancers), and patients affected with HIV and mental health issues. Finally, we also add a perspective on Ayurvedic treatment and its efficacy on COVID-19 patients.
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Breccia M, Abruzzese E, Accurso V, Attolico I, Barulli S, Bergamaschi M, Binotto G, Bocchia M, Bonifacio M, Caocci G, Capodanno I, Castagnetti F, Cavazzini F, Crisà E, Crugnola M, Stella De Candia M, Elena C, Fava C, Galimberti S, Gozzini A, Gugliotta G, Intermesoli T, Iurlo A, La Barba G, Latagliata R, Leonetti Crescenzi S, Levato L, Loglisci G, Lucchesi A, Luciano L, Lunghi F, Luzi D, Malato A, Cristina Miggiano M, Pizzuti M, Pregno P, Rapezzi D, Rege-Cambrin G, Rosti G, Russo S, Sancetta R, Rita Scortechini A, Sorà F, Sportoletti P, Stagno F, Tafuri A, Tiribelli M, Foà R, Saglio G. COVID-19 infection in chronic myeloid leukaemia after one year of the pandemic in Italy. A Campus CML report. Br J Haematol 2021; 196:559-565. [PMID: 34636033 PMCID: PMC8652631 DOI: 10.1111/bjh.17890] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 09/21/2021] [Accepted: 09/27/2021] [Indexed: 11/30/2022]
Abstract
Limited information is available on the impact of the COVID-19 pandemic on the management of chronic myeloid leukaemia (CML). The Campus CML network collected retrospective information on 8 665 CML patients followed at 46 centres throughout Italy during the pandemic between February 2020 and January 2021. Within this cohort, we recorded 217 SARS-CoV-2-positive patients (2·5%). Most patients (57%) were diagnosed as having SARS-CoV-2 infection during the second peak of the pandemic (September 2020 to January 2021). The majority (35%) was aged between 50 and 65 years with a male prevalence (73%). Fifty-six percent of patients presented concomitant comorbidities. The median time from CML diagnosis to SARS-CoV-2 infection was six years (three months to 18 years). Twenty-one patients (9·6%) required hospitalization without the need of respiratory assistance, 18 (8·2%) were hospitalized for respiratory assistance, 8 (3·6%) were admitted to an intensive care unit, while 170 (78%) were only quarantined. Twenty-three percent of patients discontinued tyrosine kinase inhibitor (TKI) therapy during the infection. Twelve patients died due to COVID-19 with a mortality rate of 5·5% in the positive cohort and of 0·13% in the whole cohort. We could also document sequelae caused by the SARS-CoV-2 infection and an impact of the pandemic on the overall management of CML patients.
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Affiliation(s)
- Massimo Breccia
- Department of Translational and Precision Medicine, Sapienza University, Roma, Italy
| | | | - Vincenzo Accurso
- UO di Ematologia con Trapianto, AU Policlinico Paolo Giaccone, Palermo, Italy
| | - Immacolata Attolico
- UO Ematologia con Trapianto, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Sara Barulli
- Divisione di Ematologia di Muraglia, CTMO Ospedale San Salvatore, Pesaro, Italy
| | | | - Gianni Binotto
- Ematologia ed Immunologia Clinica, Università degli Studi di Padova, Padova, Italy
| | - Monica Bocchia
- U.O.C. Ematologia e Trapianti, A.O. Senese - Policlinico 'Le Scotte', Siena, Italy
| | - Massimiliano Bonifacio
- Divisione di Ematologia, Istituti Ospitalieri di Verona, Policlinico G.B. Rossi, Verona, Italy
| | | | | | - Fausto Castagnetti
- Istituto di Ematologia 'Lorenzo e A. Seragnoli', Policlinico S. Orsola-Malpighi, Bologna, Italy
| | | | - Elena Crisà
- S.C.D.U. Ematologia - DIMECS e Dipartimento Oncologico, Università del Piemonte Orientale Amedeo Avogadro, Novara, Italy
| | | | | | - Chiara Elena
- Ematologia, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Carmen Fava
- A.S.O. Ordine Mauriziano, P.O. Umberto I, Struttura Complessa a Direzione Universitaria-Ematologia e Terapie Cellulari, Torino, Italy
| | - Sara Galimberti
- Ematologia, Università di Pisa - Azienda Ospedaliera Pisana, Pisa, Italy
| | - Antonella Gozzini
- Unità di Ricerca e di Malattie del Sangue, Ematologia San Luca Vecchio, Firenze, Italy
| | - Gabriele Gugliotta
- Istituto di Ematologia 'Lorenzo e A. Seragnoli', Policlinico S. Orsola-Malpighi, Bologna, Italy
| | | | - Alessandra Iurlo
- UOC Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | | | | | | | | | | | - Alessandro Lucchesi
- Ematologia, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy
| | - Luigiana Luciano
- Ematologia, Azienda Ospedaliera Universitaria - Università degli Studi di Napoli 'Federico II', Napoli, Italy
| | | | - Debora Luzi
- Ematologia, A.O. Santa Maria - Terni S.C Oncoematologia, Terni, Italy
| | | | | | | | - Patrizia Pregno
- Dipartimento di Oncologia ed Ematologia S.C. Ematologia 2, A.O. Città della Salute e della Scienza di Torino S. G. Battista, Torino, Italy
| | | | - Giovanna Rege-Cambrin
- Dipartimento di Scienze Cliniche e Biologiche, Ospedale S. Luigi Gonzaga-Medicina Interna 2, Orbassano, Italy
| | - Gianantonio Rosti
- Ematologia, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy
| | - Sabina Russo
- Dipartimento di Medicina Interna, Azienda Ospedaliera Universitaria - Policlinico G. Martino, Messina, Italy
| | | | | | - Federica Sorà
- Ematologia, Policlinico Gemelli - Università Cattolica del Sacro Cuore, Roma, Italy
| | | | - Fabio Stagno
- Hematology Section and BMT Unit, AOU Policlinico 'Rodolico-San Marco', Catania, Italy
| | | | - Mario Tiribelli
- Clinica Ematologica-Centro Trapianti e Terapie cellulari, Azienda Ospedaliero-Universitaria, Udine, Italy
| | - Robin Foà
- Department of Translational and Precision Medicine, Sapienza University, Roma, Italy
| | - Giuseppe Saglio
- A.S.O. Ordine Mauriziano, Struttura Complessa a Direzione Universitaria-Ematologia e Terapie Cellulari-, P.O. Umberto I, Torino, Italy
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8
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Suttorp M, Webster Carrion A, Hijiya N. Chronic Myeloid Leukemia in Children: Immune Function and Vaccinations. J Clin Med 2021; 10:jcm10184056. [PMID: 34575167 PMCID: PMC8470625 DOI: 10.3390/jcm10184056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/31/2021] [Accepted: 08/31/2021] [Indexed: 12/26/2022] Open
Abstract
Children with CML need TKI treatment for many years, and the lack of knowledge about immune dysfunction with TKI has hindered routine immunizations. This review attempts to provide an overview of the effects of TKIs licensed for children (e.g., imatinib, dasatinib, and nilotinib) on immune function, as well as its implications on immunizations. We discuss surveillance strategies (e.g., immunoglobulin blood serum levels and hepatitis B reactivation) and immunizations. All inactivated vaccines (e.g., influenza, pneumococcal, and streptococcal) can be given during the treatment of CML in the chronic phase, although their efficacy may be lower. As shown in single cases of children and adults with CML, live vaccines (e.g., varicella, measles, mumps, rubella, and yellow fever) may be administered under defined circumstances with great precautions. We also highlight important aspects of COVID-19 in this patient population (e.g., the outcome of COVID-19 infection in adults with CML and in children with varying hemato-oncological diseases) and discuss the highly dynamic field of presently available different vaccination options. In conclusion, TKI treatment for CML causes humoral and cellular immune dysfunction, which is mild in most patients, and thus infectious complications are rare. Routine immunizations are important for health maintenance of children, but vaccinations for children with CML on TKI therapy should be carefully considered.
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Affiliation(s)
- Meinolf Suttorp
- Hematology and Oncology, Medical Faculty, Technical University, D-01307 Dresden, Germany
- Correspondence:
| | - Andrea Webster Carrion
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University Medical Center, New York, NY 10032, USA; (A.W.C.); (N.H.)
| | - Nobuko Hijiya
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Columbia University Medical Center, New York, NY 10032, USA; (A.W.C.); (N.H.)
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9
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Bonifacio M, Tiribelli M, Miggiano MC, Abruzzese E, Binotto G, Scaffidi L, Cordioli M, Damiani D, Di Bona E, Trawinska MM, Tanasi I, Dubbini MV, Velotta V, Ceccarelli G, Pierdomenico E, Lo Schirico M, Semenzato G, Ruggeri M, Fanin R, Tacconelli E, Pizzolo G, Krampera M. The serological prevalence of SARS-CoV-2 infection in patients with chronic myeloid leukemia is similar to that in the general population. Cancer Med 2021; 10:6310-6316. [PMID: 34464516 PMCID: PMC8446554 DOI: 10.1002/cam4.4179] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 06/30/2021] [Accepted: 07/28/2021] [Indexed: 12/18/2022] Open
Abstract
Background Patients with hematological malignancies are at an increased risk of SARS‐CoV‐2 disease (COVID‐19) and adverse outcome. However, a low mortality rate has been reported in patients with chronic myeloid leukemia (CML). Preclinical evidence suggests that tyrosine kinase inhibitors (TKIs) may have a protective role against severe COVID‐19. Methods We conducted a cross‐sectional study of 564 consecutive patients with CML who were tested for anti‐SARS‐CoV‐2 IgG/IgM antibodies at their first outpatient visit between May and early November 2020 in five hematologic centers representative of three Italian regions. Results The estimated serological prevalence of SARS‐CoV‐2 infection in patients with CML after the first pandemic wave was similar to that in the general population (about 2%), both at national and regional levels. CML patients with positive anti‐SARS‐CoV‐2 serology were more frequently male (p = 0.027) and active workers (p = 0.012), while there was no significant association with TKI treatment type. Only 3 out of 11 IgG‐positive patients had previously received a molecular diagnosis of COVID‐19, while the remainders were asymptomatic or with mild symptoms. Conclusions Our data confirm that the course of SARS‐CoV‐2 infection in patients with CML is generally mild and reassure about the safety of continuing TKIs during the COVID‐19 pandemic. Furthermore, we suggest that patients with CML succeed to mount an antibody response after exposure to SARS‐CoV‐2, similar to the general population.
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Affiliation(s)
| | - Mario Tiribelli
- Division of Hematology and BMT, Department of Medical Area, University of Udine, Udine, Italy
| | - Maria Cristina Miggiano
- Hematology Department, San Bortolo Hospital, Azienda ULSS8 "Berica" of Vicenza, Vicenza, Italy
| | | | - Gianni Binotto
- Padua School of Medicine, Department of Medicine, Hematology and Clinical Immunology, Padua, Italy
| | - Luigi Scaffidi
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Maddalena Cordioli
- Department of Diagnostics and Public Health, Section of Infectious Diseases, University of Verona, Verona, Italy
| | - Daniela Damiani
- Division of Hematology and BMT, Department of Medical Area, University of Udine, Udine, Italy
| | - Eros Di Bona
- Hematology Department, San Bortolo Hospital, Azienda ULSS8 "Berica" of Vicenza, Vicenza, Italy
| | | | - Ilaria Tanasi
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Maria Vittoria Dubbini
- Division of Hematology and BMT, Department of Medical Area, University of Udine, Udine, Italy
| | - Vanessa Velotta
- Hematology, S. Eugenio Hospital, ASL Roma2, Tor Vergata University, Rome, Italy
| | - Giulia Ceccarelli
- Hematology, S. Eugenio Hospital, ASL Roma2, Tor Vergata University, Rome, Italy
| | - Elisabetta Pierdomenico
- Padua School of Medicine, Department of Medicine, Hematology and Clinical Immunology, Padua, Italy
| | - Mariella Lo Schirico
- Padua School of Medicine, Department of Medicine, Hematology and Clinical Immunology, Padua, Italy
| | - Gianpietro Semenzato
- Padua School of Medicine, Department of Medicine, Hematology and Clinical Immunology, Padua, Italy
| | - Marco Ruggeri
- Hematology Department, San Bortolo Hospital, Azienda ULSS8 "Berica" of Vicenza, Vicenza, Italy
| | - Renato Fanin
- Division of Hematology and BMT, Department of Medical Area, University of Udine, Udine, Italy
| | - Evelina Tacconelli
- Department of Diagnostics and Public Health, Section of Infectious Diseases, University of Verona, Verona, Italy
| | - Giovanni Pizzolo
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Mauro Krampera
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
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10
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Abstract
PURPOSE OF REVIEW The spread of the novel coronavirus SARS-CoV-2 and its associated disease, coronavirus disease of 2019 (COVID-19), has significantly derailed cancer care. Patients with leukemia are more likely to have severe infection and increased rates of mortality. There is paucity of information on how to modify care of leukemia patients in view of the COVID-19 risks and imposed restrictions. We review the available literature on the impact of COVID-19 on different types of leukemia patients and suggest general as well as disease-specific recommendations on care based on available evidence. RECENT FINDINGS The COVID-19 infection impacts leukemia subtypes in variable ways and the standard treatments for leukemia have similarly, varying effects on the course of COVID-19 infection. Useful treatment strategies include deferring treatment when possible, use of less intensive regimens, outpatient targeted oral agents requiring minimal monitoring, and prioritization of curative or life-prolonging strategies. Reducing health care encounters, rational transfusion standards, just resource allocation, and pre-emptive advance care planning will serve the interests of leukemia patients. Ad hoc modifications based on expert opinions and extrapolations of previous well-designed studies are the way forward to navigate the crisis. This should be supplanted with more rigorous prospective evidence.
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Affiliation(s)
- Nabin Raj Karki
- Division of Hematology/Oncology, Augusta University, Augusta, GA, USA
| | - Thuy Le
- Division of Hematology/Oncology, Augusta University, Augusta, GA, USA
| | - Jorge Cortes
- Division of Hematology/Oncology, Augusta University, Augusta, GA, USA.
- Georgia Cancer Center, Augusta University, 1410 Laney Walker Rd., CN2222, Augusta, GA, 30912, USA.
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11
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Pagnano KB, Peralta EH, Navarro JR, David Salas LDR, Delgado N, Moiraghi B, Toreli ACM, Perobelli LM, Fechio L, Quixada ATS, Funke V, Bendit I, Seguro FS, Pilleux L, Bortolini J, Lourenço ALG, Sapelli J, Nucci FM, Pavlovsky C, Oliveira LDC, Moura MS, Palma LC, Gonçalves NN, Conchon M, Hokama POM, Almeida LL, Zulli R, de Souza CA, Boquimpani CM. COVID-19 in chronic myeloid leukemia patients in Latin America. Leuk Lymphoma 2021; 62:3212-3218. [PMID: 34254886 DOI: 10.1080/10428194.2021.1950709] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This observational, multicenter study aimed to report the clinical evolution of COVID-19 in patients with chronic myeloid leukemia in Latin America. A total of 92 patients presented with COVID-19 between March and December 2020, 26% of whom were severe or critical. The median age at COVID-19 diagnosis was 48 years (22-79 years), 32% were 60 years or older, and 61% were male. Thirty-nine patients presented with at least one comorbidity (42.3%). Eighty-one patients recovered (88%), and 11 (11.9%) died from COVID-19. There was one case of reinfection. Patients with a major molecular response presented superior overall survival compared to patients with no major molecular response (91 vs. 61%, respectively; p = 0.004). Patients in treatment-free remission and receiving tyrosine kinase inhibitors showed higher survival rates than patients who underwent hematopoietic stem cell transplantation and those who did not receive tyrosine kinase inhibitors (100, 89, 50, and 33%, respectively; p < 0.001).
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Affiliation(s)
- Katia B Pagnano
- Hematology and Hemotherapy Center, University of Campinas, Campinas, SP, Brazil
| | | | | | | | - Nancy Delgado
- Centro Médico Nacional Siglo XXI IMSS, Cuauhtémoc, México Ciudad de México
| | | | | | - Leila M Perobelli
- Hospital de Transplantes Euryclides de Jesus Zerbini, São Paulo, Brazil
| | - Leonardo Fechio
- Hematology and Hemotherapy Center, University of Campinas, Campinas, SP, Brazil
| | - Acy T S Quixada
- Faculdade de Medicina da Universidade Federal do Ceará, Hospital Universitário Walter Cantídio, Fortaleza, Brazil
| | - Vaneuza Funke
- Complexo Hospital de Clínicas - Universidade Federal do Paraná, Curitiba, Brazil
| | - Israel Bendit
- Laboratory of Medical Investigation in Pathogenesis and targeted therapy in Onco-Immuno-Hematology (LIM/31), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Fernanda S Seguro
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | | | - Fabio M Nucci
- Hospital Universitário Antonio Pedro, Universidade Federal Fluminense, Niterói, Brazil
| | | | | | | | - Leonardo C Palma
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | | | | | - Paula O M Hokama
- São Paulo State University, UNESP, Medical School, Campus de Botucatu, Botucatu, Brazil
| | | | - Roberto Zulli
- Hematology and Hemotherapy Center, University of Campinas, Campinas, SP, Brazil
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12
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McCaughan G, Di Ciaccio P, Ananda-Rajah M, Gilroy N, MacIntyre R, Teh B, Weinkove R, Curnow J, Szer J, Enjeti AK, Ross DM, Mulligan S, Trotman J, Dickinson M, Quach H, Choi P, Polizzotto MN, Tam CS, Ho PJ, Ku M, Gregory G, Gangatharan S, Hapgood G, Cochrane T, Cheah C, Gibbs S, Wei A, Johnston A, Greenwood M, Prince HM, Latimer M, Berkahn L, Wight J, Armytage T, Hamad N. COVID-19 vaccination in haematology patients: an Australian and New Zealand consensus position statement. Intern Med J 2021; 51:763-768. [PMID: 34047035 PMCID: PMC8206846 DOI: 10.1111/imj.15247] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Indexed: 12/11/2022]
Abstract
Australia and New Zealand have achieved excellent community control of COVID-19 infection. In light of the imminent COVID-19 vaccination roll out in both countries, representatives from the Haematology Society of Australia and New Zealand and infectious diseases specialists have collaborated on this consensus position statement regarding COVID-19 vaccination in patients with haematological disorders. It is our recommendation that patients with haematological malignancies, and some benign haematological disorders, should have expedited access to high-efficacy COVID-19 vaccines, given that these patients are at high risk of morbidity and mortality from COVID-19 infection. Vaccination should not replace other public health measures in these patients, given that the effectiveness of COVID-19 vaccination, specifically in patients with haematological malignancies, is not known. Given the limited available data, prospective collection of safety and efficacy data of COVID-19 vaccination in this patient group is a priority.
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Affiliation(s)
- Georgia McCaughan
- Department of Haematology, St Vincent's Hospital, Sydney, New South Wales, Australia.,St Vincent's Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Pietro Di Ciaccio
- Department of Haematology, St Vincent's Hospital, Sydney, New South Wales, Australia.,St Vincent's Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Michelle Ananda-Rajah
- Department of Infectious Diseases, Alfred Health and Central Clinical School, Monash University, Melbourne, Victoria, Australia.,General Medical Unit, Alfred Health, Melbourne, Victoria, Australia
| | - Nicole Gilroy
- Centre for Infectious Diseases and Clinical Microbiology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Raina MacIntyre
- Biosecurity Program, The Kirby Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Benjamin Teh
- National Centre for Infections in Cancer, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia.,Department of Infectious Diseases, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia
| | - Robert Weinkove
- Wellington Blood and Cancer Centre, Capital and Coast District Health Board, Wellington, New Zealand.,Cancer Immunotherapy Programme, Malaghan Institute of Medical Research, Wellington, New Zealand
| | - Jennifer Curnow
- Department of Haematology, Westmead Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.,Sydney Centres for Thrombosis and Haemostasis, Sydney, New South Wales, Australia
| | - Jeff Szer
- Clinical Haematology, Peter MacCallum Cancer Centre and the Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Anoop K Enjeti
- NSW Health Pathology, John Hunter Hospital, Newcastle, New South Wales, Australia.,Department of Haematology, Calvary Mater Newcastle, Newcastle, New South Wales, Australia.,School of Medicine and Public Health Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - David M Ross
- Department of Hematology and Bone Marrow Transplantation, Royal Adelaide Hospital, Adelaide, Australia.,Centre for Cancer Biology, University of South Australia and SA Pathology, Adelaide, South Australia, Australia.,Precision Medicine Theme, South Australian Health and Medical Research Institute, and Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Stephen Mulligan
- Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.,Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Chronic Lymphocytic Leukaemia Australian Research Consortium (CLLARC), Australia
| | - Judith Trotman
- Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.,Department of Haematology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - Michael Dickinson
- Clinical Haematology, Peter MacCallum Cancer Centre and the Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Hang Quach
- Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia.,Department of Haematology, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Phillip Choi
- ACRF Department of Cancer Biology and Therapeutics, The John Curtin School of Medical Research, The Australian National University, Canberra, Australian Capital Territory, Australia.,The National Platelet Research and Referral Centre (NPRC), Canberra, Australian Capital Territory, Australia.,Haematology Department, The Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Mark N Polizzotto
- Department of Haematology, St Vincent's Hospital, Sydney, New South Wales, Australia.,St Vincent's Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.,The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Constantine S Tam
- Clinical Haematology, Peter MacCallum Cancer Centre and the Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia.,Department of Haematology, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - P Joy Ho
- Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.,Department of Haematology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Matthew Ku
- Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia.,Department of Haematology, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Gareth Gregory
- Department of Haematology, Monash Health, Melbourne, Victoria, Australia
| | - Shane Gangatharan
- Faculty of Medicine, University of Western Australia, Perth, Western Australia, Australia.,Department of Haematology, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Greg Hapgood
- Department of Haematology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Tara Cochrane
- Department of Haematology, Gold Coast University Hospital, Gold Coast, Queensland, Australia.,Faculty of Medicine, Griffith University, Brisbane, Queensland, Australia
| | - Chan Cheah
- Faculty of Medicine, University of Western Australia, Perth, Western Australia, Australia.,Department of Haematology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,Department of Haematology, Pathwest Laboratory Medicine, Perth, Western Australia, Australia
| | - Simon Gibbs
- Department of Haematology, Eastern Health, Melbourne, Victoria, Australia.,Faculty of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Andrew Wei
- Department of Clinical Hematology, The Alfred Hospital, Melbourne, Victoria, Australia.,Australian Centre for Blood Diseases, Monash University, Melbourne, Victoria, Australia
| | - Anna Johnston
- Department of Haematology, The Royal Hobart Hospital, Hobart, Tasmania, Australia.,Faculty of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Matthew Greenwood
- Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.,Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - H Miles Prince
- Clinical Haematology, Peter MacCallum Cancer Centre and the Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia.,Department of Haematology, Epworth Healthcare, Melbourne, Victoria, Australia
| | - Maya Latimer
- Haematology Department, The Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Leanne Berkahn
- Department of Haematology, The Auckland City Hospital, Auckland, New Zealand.,Faculty of Medicine, University of Auckland, Auckland, New Zealand
| | - Joel Wight
- Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia.,Faculty of Medicine, Townsville University Hospital, Townsville, Queensland, Australia
| | - Tasman Armytage
- Department of Haematology, Gosford Hospital, Gosford, New South Wales, Australia
| | - Nada Hamad
- Department of Haematology, St Vincent's Hospital, Sydney, New South Wales, Australia.,St Vincent's Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
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13
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Demichelis-Gómez R, Alvarado-Ibarra M, Vasquez-Chávez J, Delgado-López N, Gómez-Cortés C, Espinosa-Bautista K, Cooke-Tapia A, Milán-Salvatierra A, Gómez-De León A, Lee-Tsai YL, Rosales-López D, Cabrera-García Á, Amador-Medina F, Córdoba-Ramírez A, Murrieta-Álvarez I, Solís-Poblano JC, Apodaca-Chávez E, Rangel-Patiño J, Álvarez-Vera JL, Arana-Luna L, De la Peña-Celaya JA, Espitia-Ríos ME, Hernández-Ruiz E, Pérez-Zúñiga JM, Peña-López E, González-Rivera R, García-Leyva MF, Tejeda-Romero M, Cruz-Rico J, Balderas-Delgado C, Ruíz-Argüelles GJ, Gómez-Almaguer D. Treating Acute Leukemia During the COVID-19 Pandemic in an Environment With Limited Resources: A Multicenter Experience in Four Latin American Countries. JCO Glob Oncol 2021; 7:577-584. [PMID: 33891480 PMCID: PMC8162972 DOI: 10.1200/go.20.00620] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
PURPOSE The COVID-19 pandemic is a colossal challenge for global health; nonetheless, specific subgroups face considerably higher risks for infection and mortality. Among patients with malignant diseases, those with hematologic neoplasms are at a higher risk for poor outcomes. The objective of this study was to register treatment modifications associated with the COVID-19 pandemic and their short-term consequences in Latin America. METHODS Multicenter, prospective, observational, cohort study including patients older than 14 years from 14 centers in four countries (Mexico, Peru, Guatemala, and Panama) who had a confirmed diagnosis of acute leukemia, and who were undergoing active treatment since the first COVID-19 case in each country until the cutoff on July 15, 2020. RESULTS We recruited 635 patients. Treatment modifications because of the COVID-19 pandemic were reported in 40.8% of cases. The main reason for such modifications was logistic issues (55.0%) and the most frequent modification was chemotherapy delay (42.0%). A total of 13.1% patients developed COVID-19 disease, with a mortality of 37.7%. Several factors were identified as independently associated with mortality, including a diagnosis of acute myeloid leukemia (odds ratio 2.38 [95% CI, 1.47 to 3.84]; P < .001), while the use of telemedicine was identified as a protective factor (odds ratio 0.36 [95% CI, 0.18 to 0.82]; P = .014). CONCLUSION These results highlight the collateral damage of COVID-19 in oncology patients.
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Affiliation(s)
| | | | | | - Nancy Delgado-López
- Hospital de Especialidades, Centro Médico Nacional siglo XXI, Mexico City, Mexico
| | - Cynthia Gómez-Cortés
- Hospital de Especialidades, Centro Médico Nacional siglo XXI, Mexico City, Mexico
| | | | - Ana Cooke-Tapia
- Complejo Hospitalario Doctor Arnulfo Arias Madrid, Panama, Panama
| | | | - Andrés Gómez-De León
- Universidad Autónoma de Nuevo Léon, Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
| | | | | | | | | | | | | | | | - Elia Apodaca-Chávez
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Juan Rangel-Patiño
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Luara Arana-Luna
- Centro Médico Nacional 20 de noviembre, ISSSTE, Mexico City, Mexico
| | | | | | | | | | | | - Rosa González-Rivera
- Hospital de Especialidades, Centro Médico Nacional siglo XXI, Mexico City, Mexico
| | | | | | | | | | | | - David Gómez-Almaguer
- Universidad Autónoma de Nuevo Léon, Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
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14
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Wang LQ, Tan Su Yin E, Wei GQ, Hu YX, Nagler A, Huang H. Weathering the storm: COVID-19 infection in patients with hematological malignancies. J Zhejiang Univ Sci B 2021; 21:921-939. [PMID: 33843158 PMCID: PMC7759451 DOI: 10.1631/jzus.b2000423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Within a matter of months, this highly contagious novel virus has led to a global outbreak and is still spreading rapidly across continents. In patients with COVID-19, underlying chronic diseases and comorbidities are associated with dismal treatment outcomes. Owing to their immunosuppressive status, patients with hematological malignancies (HMs) are at an increased risk of infection and have a worse prognosis than patients without HMs. Accordingly, intensive attention should be paid to this cohort. In this review, we summarize and analyze specific clinical manifestations for patients with coexisting COVID-19 and HMs. Furthermore, we briefly describe customized management strategies and interventions for this susceptible cohort. This review is intended to guide clinical practice.
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Affiliation(s)
- Lin-Qin Wang
- Bone Marrow Transplantation Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.,Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China.,Institute of Hematology, Zhejiang University, Hangzhou 310058, China.,Zhejiang Laboratory for Systems & Precision Medicine, Zhejiang University Medical Center, Hangzhou 310058, China
| | - Elaine Tan Su Yin
- Bone Marrow Transplantation Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.,Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China.,Institute of Hematology, Zhejiang University, Hangzhou 310058, China.,Zhejiang Laboratory for Systems & Precision Medicine, Zhejiang University Medical Center, Hangzhou 310058, China
| | - Guo-Qing Wei
- Bone Marrow Transplantation Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.,Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China.,Institute of Hematology, Zhejiang University, Hangzhou 310058, China.,Zhejiang Laboratory for Systems & Precision Medicine, Zhejiang University Medical Center, Hangzhou 310058, China
| | - Yong-Xian Hu
- Bone Marrow Transplantation Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.,Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China.,Institute of Hematology, Zhejiang University, Hangzhou 310058, China.,Zhejiang Laboratory for Systems & Precision Medicine, Zhejiang University Medical Center, Hangzhou 310058, China
| | - Arnon Nagler
- Hematology and Bone Marrow Transplantation Division, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel
| | - He Huang
- Bone Marrow Transplantation Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.,Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China.,Institute of Hematology, Zhejiang University, Hangzhou 310058, China.,Zhejiang Laboratory for Systems & Precision Medicine, Zhejiang University Medical Center, Hangzhou 310058, China
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15
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Berber B, Doluca O. A comprehensive drug repurposing study for COVID19 treatment: novel putative dihydroorotate dehydrogenase inhibitors show association to serotonin-dopamine receptors. Brief Bioinform 2021; 22:1023-1037. [PMID: 33406218 PMCID: PMC7929379 DOI: 10.1093/bib/bbaa379] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/26/2020] [Accepted: 11/26/2020] [Indexed: 12/18/2022] Open
Abstract
Dihydroorotate dehydrogenase (DHODH) is a key enzyme required for de novo pyrimidine synthesis and it is suggested as a target for COVID19 treatment due to high pyrimidine demand by the virus replication in the infected host cells as well as its proven effect of blocking of cytokine release by the immune cells to prevent inflammation leading to acute respiratory distress. There are a number of clinical trials underway for COVID19 treatment using DHODH inhibitors; however, there are only a small number of known DHODH antagonists available for testing. Here, we have applied a methodology to identify DHODH antagonist candidates, and compared them using in silico target prediction tools. A large set of 7900 FDA-approved and clinical stage drugs obtained from DrugBank were docked against 20 different structures DHODH available in PDB. Drugs were eliminated according to their predicted affinities by Autodock Vina. About 28 FDA-approved and 79 clinical trial ongoing drugs remained. The mode of interaction of these molecules was analyzed by repeating docking using Autodock 4 and DS Visualiser. Finally, the target region predictions of 28 FDA-approved drugs were determined through PASS and SwissTargetPrediction tools. Interestingly, the analysis of in silico target predictions revealed that serotonin-dopamine receptor antagonists could also be potential DHODH inhibitors. Our candidates shared a common attribute, a possible interaction with serotonin-dopamine receptors as well as other oxidoreductases, like DHODH. Moreover, the Bruton Tyrosine Kinase-inhibitor acalabrutunib and serotonin-dopamine receptor inhibitor drugs on our list have been found in the literature that have shown to be effective against Sars-CoV-2, while the path of activity is yet to be identified. Identifying an effective drug that can suppress both inflammation and virus proliferation will play a crucial role in the treatment of COVID. Therefore, we suggest experimental investigation of the 28 FDA-approved drugs on DHODH activity and Sars-CoV-2 virus proliferation. Those who are found experimentally effective can play an important role in COVID19 treatment. Moreover, we suggest investigating COVID19 case conditions in patients using schizophrenia and depression drugs.
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Affiliation(s)
- Burak Berber
- Eskisehir Technical University, Department of Biology
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Singh B, Ayad S, Kaur P, Kumar V, Gupta S, Maroules M. COVID-19-Induced Pancytopenia in a Major Molecular Response CML Patient on Dasatinib: A Case Report and Review of the Literature. Eur J Case Rep Intern Med 2021; 8:002233. [PMID: 33585346 DOI: 10.12890/2021_002233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 12/23/2020] [Indexed: 11/05/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), has caused a global health crisis. COVID-19 can have a multifaceted presentation, and a wide range of complications and outcomes may emerge based on the severity and comorbidities of the infected patient. We report the case of a 42-year-old man with a history of chronic myeloid leukaemia (CML) on dasatinib (in major molecular response) who was diagnosed with COVID-19 and developed pancytopenia. Our case report and review of available publications add to the limited literature available regarding COVID-19 in CML. LEARNING POINTS Our case report and review of the literature highlight the multifaceted response in chronic myeloid leukaemia (CML) patients to COVID-19 (respiratory symptoms, pancytopenia, severe haemolytic anaemia and haemophagocytic lymphohistiocytosis, disseminated erythematous papular skin rash).The rates of intensive care unit admission and mechanical ventilation support, and lengths of hospital stay were lower in COVID-19 patients with CML receiving tyrosine kinase inhibitors (TKI) compared with an age, gender and comorbidity-matched control group.Our case report and review of the literature suggest a possible protective effect of TKI therapy against COVID-19 in patients with CML.
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Affiliation(s)
- Balraj Singh
- Department of Hematology & Oncology, Saint Joseph's University Medical Center, Paterson, NJ, USA
| | - Sarah Ayad
- Department of Hematology & Oncology, Saint Joseph's University Medical Center, Paterson, NJ, USA
| | - Parminder Kaur
- Department of Cardiology, Saint Joseph's University Medical Center, Paterson, NJ, USA
| | - Vinod Kumar
- Department of Hematology & Oncology, Saint Joseph's University Medical Center, Paterson, NJ, USA
| | - Sachin Gupta
- Department of Internal Medicine, Tower Health Reading Hospital, West Reading, PA, USA
| | - Michael Maroules
- Department of Hematology & Oncology, Saint Joseph's University Medical Center, Paterson, NJ, USA
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17
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Bao M, Yang S, Gale RP, Zhang Y, Liu X, Zhu H, Liang R, Liu B, Zhou L, Li Z, Dou X, Shi D, Wang T, Meng L, Li W, Jiang Q. Mental Health in Persons With Chronic Myeloid Leukemia During the SARS-CoV-2 Pandemic: The Need for Increased Access to Health Care Services. Front Psychiatry 2021; 12:679932. [PMID: 34168583 PMCID: PMC8217438 DOI: 10.3389/fpsyt.2021.679932] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 04/23/2021] [Indexed: 02/05/2023] Open
Abstract
Mental health problems in the general population have been reported during the SARS-CoV-2 pandemic; however, there were rare data in persons with chronic myeloid leukemia (CML). Therefore, we performed a cross-sectional study on mental health evaluated using the 9-item Patient Health Questionnaire (PHQ-9; depression), the 7-item Generalized Anxiety Disorder (GAD-7; anxiety), and the 22-item Impact of Event Scale-Revised (IES-R; distress), including subscales of avoidance, intrusion, and hyper-arousal in persons with CML, non-cancer persons, and immediate family members of persons with cancer as controls (≥16 years) by an online survey. Data from 3,197 persons with CML and 7,256 controls were collected. In multivariate analyses, CML was significantly associated with moderate to severe depression (OR = 1.6; 95% Confidence Interval [CI], 1.4, 1.9; p < 0.001), anxiety (OR = 1.4 [1.1, 1.7]; p = 0.001), distress (OR = 1.3 [1.1, 1.5]; p < 0.001), and hyper-arousal (OR = 1.5 [1.3, 1.6]; p < 0.001). Moreover, delay in regular monitoring was significantly associated with depression (OR 1.3 [1.0, 1.7]; p = 0.024), anxiety (OR = 1.3 [1.0, 1.8]; p = 0.044), avoidance (OR = 1.2 [1.0, 1.4]; p = 0.017), and intrusion (OR = 1.2 [1.0, 1.4]; p = 0.057); tyrosine kinase-inhibitor dose reduction or discontinuation, depression (OR = 1.9 [1.3, 2.8]; p = 0.001), distress (OR = 2.0 [1.4, 2.8]; p < 0.001), avoidance (OR = 1.6 [1.2, 2.1]; p = 0.004), intrusion (OR = 1.6 [1.1, 2.1]; p = 0.006), and hyper-arousal (OR = 1.3 [1.0, 1.8]; p = 0.088). We concluded that persons with CML during the SARS-CoV-2 pandemic have worse mental health including depression, anxiety, and distress symptoms. Decreasing or stopping monitoring or dose resulted in adverse mental health consequences.
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Affiliation(s)
- Mei Bao
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Sen Yang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Robert Peter Gale
- Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, United Kingdom
| | - Yanli Zhang
- Department of Hematology, Henan Provincial Tumor Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoli Liu
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Huanling Zhu
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, China
| | - Rong Liang
- Department of Hematology, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Bingcheng Liu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology, Chinese Academy of Medical Sciences, Tianjin, China
| | - Li Zhou
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zongru Li
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Xuelin Dou
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Dayu Shi
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Tao Wang
- Department of Epidemiology and Biostatistics School of Public Health Peking University Health Science Center, Beijing, China
| | - Li Meng
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weiming Li
- Department of Hematology, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Qian Jiang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China
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18
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Imatinib is not a potent anti-SARS-CoV-2 drug. Leukemia 2020; 34:3085-3087. [PMID: 32999432 PMCID: PMC7527150 DOI: 10.1038/s41375-020-01045-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/13/2020] [Accepted: 09/23/2020] [Indexed: 12/31/2022]
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19
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Yılmaz U, Pekmezci A, Gül Y, Eşkazan AE. COVID-19 in Chronic-Phase Chronic Myeloid Leukemia Patients: A Single-Center Survey from Turkey. Turk J Haematol 2020; 38:79-81. [PMID: 32964857 PMCID: PMC7927441 DOI: 10.4274/tjh.galenos.2020.2020.0472] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Umut Yılmaz
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
| | - Aslıhan Pekmezci
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, İstanbul, Turkey
| | - Yalçın Gül
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, İstanbul, Turkey
| | - Ahmet Emre Eşkazan
- İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Division of Hematology, İstanbul, Turkey
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