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Review
. 2023 Oct 19:13:1207225.
doi: 10.3389/fcimb.2023.1207225. eCollection 2023.

Omicron related COVID-19 prevention and treatment measures for patients with hematological malignancy and strategies for modifying hematologic treatment regimes

Wenjing Guo  1   2 , Yizhou Zheng  1   2 , Sizhou Feng  1   2
Affiliations
Review

Omicron related COVID-19 prevention and treatment measures for patients with hematological malignancy and strategies for modifying hematologic treatment regimes

Wenjing Guo et al. Front Cell Infect Microbiol. .

Abstract

The Omicron variant of SARS-CoV-2 has rapidly become the dominant strain worldwide due to its high transmissibility, although it appears to be less pathogenic than previous strains. However, individuals with hematological malignancy (HM) and COVID-19 remain susceptible to severe infection and mortality, especially those with chronic lymphocytic leukemia (CLL) and those undergoing chimeric antigen receptor T-cell (CAR-T) treatment. Hematologists should thoroughly assess the severity of the patient's hematological disease and the potential risk of SARS-CoV-2 infection before initiating chemotherapy or immunosuppressive treatment. Vaccination and booster doses are strongly recommended and patients with a poor vaccine response may benefit from long-acting COVID-19 neutralizing monoclonal antibodies (such as Evusheld). Early use of small molecule antiviral drugs is recommended for managing mild COVID-19 in HM patients and those with severe immunodeficiency may benefit from SARS-CoV-2 neutralizing monoclonal antibody therapy and high-titer COVID-19 convalescent plasma (CCP). For moderate to severe cases, low-dose glucocorticoids in combination with early antiviral treatment can be administered, with cytokine receptor antagonists or JAK inhibitors added if the condition persists or worsens. In the treatment of hematological malignancies, delaying chemotherapy is preferable for CLL, acute leukemia (AL), and low-risk myelodysplastic syndrome (MDS), but if the disease progresses, appropriate adjustments in dosage and frequency of treatment are required, with the avoidance of anti-CD20 monoclonal antibody, CAR-T and hematopoietic stem cell transplantation (HSCT). Patients with chronic myelocytic leukemia (CML) and myeloproliferative neoplasms (MPNs) can continue current treatment. What's more, non-drug protective measures, the development of new vaccines and antiviral drugs, and monitoring of mutations in immunocompromised populations are particularly important.

Keywords: Omicron; SARS-CoV-2; hematological malignancy; immunocompromise; treatment.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Figure 1
Figure 1
Prevention and treatment of patients with hematological malignancies in the Omicron era.
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References

    1. Abdul-Jawad S., Baù L., Alaguthurai T., Del Molino Del Barrio I., Laing A. G., Hayday T. S., et al. . (2021). Acute immune signatures and their legacies in severe acute respiratory syndrome coronavirus-2 infected cancer patients. Cancer Cell 39 (2), 257–275. doi: 10.1016/j.ccell.2021.01.001 - DOI - PMC - PubMed
    1. Aiello T.-F., Puerta-Alcalde P., Chumbita M., Lopera C., Monzó P., Cortes A., et al. . (2023). Current outcomes of SARS-CoV-2 Omicron variant infection in high-risk haematological patients treated early with antivirals. J. Antimicrobial Chemotherapy 78 (6), 1454–1459. doi: 10.1093/jac/dkad105 - DOI - PubMed
    1. Ali E. A., Khamees I., Abu-Tineh M., Qasim H., Alshurafa A., Ahmed K., et al. . (2022). SARS-CoV-2 omicron variant in patients with chronic myeloid leukemia: A retrospective study. Cureus 14 (4), e23863. doi: 10.7759/cureus.23863 - DOI - PMC - PubMed
    1. Ali E., Khamees I., Alshurafa A., Qasim H., Abu-Tineh M. A., Ahmed K., et al. . (2022). Severe acute respiratory syndrome coronavirus 2 omicron variant in patients with philadelphia-negative myeloproliferative neoplasm: A single center experience. Oncology 100 (8), 460–466. doi: 10.1159/000525750 - DOI - PubMed
    1. Altuntas F., Ata N., Yigenoglu T. N., Bascı S., Dal M. S., Korkmaz S., et al. . (2021). COVID-19 in hematopoietic cell transplant recipients. Bone Marrow Transplant. 56 (4), 952–955. doi: 10.1038/s41409-020-01084-x - DOI - PubMed

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