酪氨酸激酶抑制剂对慢性粒细胞白血病患者新型冠状病毒感染的影响  

Effects of tyrosine kinase inhibitors on chronic myeloid leukemia patients during the SARS-CoV-2 pandemic

作　　者：吴河清 聂金红 谢伊瑜 陈苏宁[1] 吴德沛[1] 吴小津[1] Wu Heqing;Nie Jinhong;Xie Yiyu;Chen Suning;Wu Depei;Wu Xiaojin(Department of Hematology,the First Affiliated Hospital of Soochow University,National Clinical Research Center for Hematologic Diseases,Jiangsu Institute of Hematology,Suzhou 215000,China;Division of Hematology and Oncology,Department of Medicine,UMass Memorial Medical Center,University of Massachusetts Chan Medical School,Worcestor,MA 01655,USA)

机构地区：[1]苏州大学附属第一医院血液科,国家血液病临床医学研究中心,江苏省血液研究所,苏州215000 [2]Division of Hematology and Oncology,Department of Medicine,UMass Memorial Medical Center,University of Massachusetts Chan Medical School,Worcestor,MA 01655,USA

出　　处：《白血病．淋巴瘤》2024年第9期534-539,共6页Journal of Leukemia & Lymphoma

基　　金：江苏省自然科学基金(BK2021070);苏州重点疾病项目(LCZX202101)。

摘　　要：目的探究新型冠状病毒流行期间服用酪氨酸激酶抑制剂(TKI)对慢性粒细胞白血病(CML)患者新型冠状病毒感染、相关症状及恢复的影响。方法回顾性病例系列研究。于2022年12月至2023年1月通过电话随访收集2021年1月至12月新型冠状病毒流行期间在苏州大学附属第一医院接受治疗的CML患者319例及其同住者547名的一般资料及新型冠状病毒感染相关信息。比较CML患者与其同住者间、是否接种新型冠状病毒疫苗、是否应用TKI的CML患者间、应用不同类型TKI的CML患者间一般临床特征及新型冠状病毒感染率、症状严重程度和恢复时间的差异;采用多因素logistic回归分析影响这三个方面的因素。结果CML患者中位年龄[M(Q 1,Q 3)]46岁(36岁,57岁),男性188例(59.0%)和女性131例(41.0%);同住者中位年龄41岁(22岁,55岁),男性266名(48.6%)和女性281名(51.4%)。CML患者和同住者间年龄、性别、是否接种新型冠状病毒疫苗、新型冠状病毒感染率[83.7%(267/319)比90.5%(495/547)]、各级症状(轻型、普通型、危重型、死亡)患者分布及恢复时间[7 d(5 d,14 d)比6 d(2 d,8 d)]差异均有统计学意义(均P<0.05)。接种新型冠状病毒疫苗的CML患者(143例)和接种疫苗的同住者(517例)间年龄、性别、新型冠状病毒感染率、各级症状患者分布及恢复时间差异均有统计学意义(均P<0.05);接种与未接种新型冠状病毒疫苗的CML患者(176例)间上述因素差异均无统计学意义(均P>0.05)。服用与未服用TKI药物的CML患者分别有297例(93.1%)和22例,两组患者年龄和性别分布差异均无统计学意义(均P>0.05),服用TKI药物患者新型冠状病毒感染率低于未服用患者[82.5%(245/297)比100.0%(22/22),P=0.032],但两组患者各级症状患者分布和恢复时间差异均无统计学意义(均P>0.05)。多因素logistic回归分析结果显示,TKI治疗是CML患者新型冠状病毒感染的独立保护因素(未服用TKI比服用ObjectiveTo explore the effects of tyrosine kinase inhibitors(TKI)on SARS-CoV-2 infection,the related symptoms,and recovery in patients with chronic myeloid leukemia(CML)during the SARS-CoV-2 epidemic.MethodsA retrospective case series study was conducted.The information including general data and SARS-CoV-2 infection of 319 CML patients treated in the First Affiliated Hospital of Soochow University from January 2021 to December 2021 and 547 co-residents during the SARS-CoV-2 epidemic was collected by telephone follow-up from December 2022 to January 2023.The differences in clinical characteristics,infection rate,symptom severity,and recovery time of the SARS-CoV-2 between CML patients and their co-residents,between patients whether getting vaccine for SARS-CoV-2,between patients whether receiving TKI and among CML patients receiving different types of TKI were compared.The multivariate logistic regression analysis was used to analyze the factors influencing the infection rate,symptom severity,and recovery time of SARS-CoV-2.ResultsThe median age[M(Q 1,Q 3)]of CML patients was 46 years(36 years,57 years)and all 319 CML patients included 188(59.0%)males and 131(41.0%)females;the median age of co-residents of CML patients was 41 years(22 years,55 years),and all 547 co-residents included 266(48.6%)males and 281(51.4%)females.There were statistically significant differences in age,gender,vaccination against SARS-CoV-2 or not,infection rate[83.7%(267/319)vs.90.5%(495/547)],distribution of symptomatic patients at different severity levels(mild,moderate,severe,and fatal),and recovery time[7 d(5 d,14 d)vs.6 d(2 d,8 d)]between CML patients and co-residents(all P<0.05).There were statistically significant differences in age,gender,SARS-CoV-2 infection rate,distribution of symptomatic patients at different severity levels and recovery time between CML patients(143 cases)and their co-residents(517 cases)who received the SARS-CoV-2 vaccine(all P<0.05);there were no statistically significant differences in age,gender,infection

关 键 词：白血病 髓系 慢性 BCR-ABL阳性 新型冠状病毒感染 酪氨酸激酶抑制剂 

分 类 号：R733.7[医药卫生—肿瘤] R511[医药卫生—临床医学]