Titre
Recommendations for the management of COVID-19 in patients with haematological malignancies or haematopoietic cell transplantation, from the 2021 European Conference on Infections in Leukaemia (ECIL 9).
Type
synthèse (review)
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Cesaro, S.
Auteure/Auteur
Ljungman, P.
Auteure/Auteur
Mikulska, M.
Auteure/Auteur
Hirsch, H.H.
Auteure/Auteur
von Lilienfeld-Toal, M.
Auteure/Auteur
Cordonnier, C.
Auteure/Auteur
Meylan, S.
Auteure/Auteur
Mehra, V.
Auteure/Auteur
Styczynski, J.
Auteure/Auteur
Marchesi, F.
Auteure/Auteur
Besson, C.
Auteure/Auteur
Baldanti, F.
Auteure/Auteur
Masculano, R.C.
Auteure/Auteur
Beutel, G.
Auteure/Auteur
Einsele, H.
Auteure/Auteur
Azoulay, E.
Auteure/Auteur
Maertens, J.
Auteure/Auteur
de la Camara, R.
Auteure/Auteur
Pagano, L.
Auteure/Auteur
Contributrices/contributeurs
von Lilienfeld-Toal, M.
de la Camara, R.
Groupes de travail
ECIL 9
Liens vers les personnes
Liens vers les unités
ISSN
1476-5551
Statut éditorial
Publié
Date de publication
2022-06
Volume
36
Numéro
6
Première page
1467
Dernière page/numéro d’article
1480
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Publication Status: ppublish
Résumé
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a novel virus that spread worldwide from 2019 causing the Coronavirus disease 19 (COVID-19) pandemic. SARS-CoV-2 infection is characterised by an initial viral phase followed in some patients by a severe inflammatory phase. Importantly, immunocompromised patients may have a prolonged viral phase, shedding infectious viral particles for months, and absent or dysfunctional inflammatory phase. Among haematological patients, COVID-19 has been associated with high mortality rate in acute leukaemia, high risk-myelodysplastic syndromes, and after haematopoietic cell transplant and chimeric-antigen-receptor-T therapies. The clinical symptoms and signs were similar to that reported for the overall population, but the severity and outcome were worse. The deferral of immunodepleting cellular therapy treatments is recommended for SARS-CoV-2 positive patient, while in the other at-risk cases, the haematological treatment decisions must be weighed between individual risks and benefits. The gold standard for the diagnosis is the detection of viral RNA by nucleic acid testing on nasopharyngeal-swabbed sample, which provides high sensitivity and specificity; while rapid antigen tests have a lower sensitivity, especially in asymptomatic patients. The prevention of SARS-CoV-2 infection is based on strict infection control measures recommended for aerosol-droplet-and-contact transmission. Vaccinations against SARS-CoV-2 has shown high efficacy in reducing community transmission, hospitalisation and deaths due to severe COVID-19 disease in the general population, but immunosuppressed/haematology patients may have lower sero-responsiveness to vaccinations. Moreover, the recent emergence of new variants may require vaccine modifications and strategies to improve efficacy in these vulnerable patients. Beyond supportive care, the specific treatment is directed at viral replication control (antivirals, anti-spike monoclonal antibodies) and, in patients who need it, to the control of inflammation (dexamethasone, anti-Il-6 agents, and others). However, the benefit of all these various prophylactic and therapeutic treatments in haematology patients deserves further studies.
PID Serval
serval:BIB_0BAF861FA408
PMID
Open Access
Oui
Date de création
2022-05-13T16:47:17.188Z
Date de création dans IRIS
2025-05-20T17:14:40Z
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41375_2022_Article_1578.pdf
Version du manuscrit
published
Taille
1.14 MB
Format
Adobe PDF
PID Serval
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Somme de contrôle
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