Professor Ma Jun: Hematological tumor patients are at high risk of severe COVID-19 and need to be comprehensively prevented

With the continuous development of the economy and the rapid improvement of medical standards, the average life expectancy of Chinese residents has greatly improved, and at the same time, the diagnosis rate of serious diseases such as tumors that are highly related to age factors has also increased

Professor Ma Jun, director of the Harbin Institute of Hematology and Oncology, told reporters that blood tumors are mainly divided into four types, one is lymphoma, the incidence rate ranks first, and the annual new cases in China are about 120,000; The second is leukemia, with about 100,000 new cases every year; The third is multiple myeloma, with about 80,000 new cases per year; The fourth is the syndrome of myelodysplastic abnormalities, with about 80,000

"Overall, once patients with blood tumors and patients receiving bone marrow transplants suffer from new crown pneumonia, there are more complications, including bleeding, infection, disease progression, etc

According to the Chinese Expert Consensus on Vaccination of Adult Patients with Hematology Diseases against Novel Coronavirus (2022 Edition) (hereinafter referred to as the Expert Consensus), patients with hematological tumors should be vaccinated as a high-risk group if there are no contraindications to vaccination

The Technical Guidelines for COVID-19 Vaccination (First Edition) (hereinafter referred to as the "Vaccination Guidelines") recommend that immunocompromised people, including patients with tumors, should receive inactivated vaccines and recombinant sub-vaccines

In general, vaccination strengthens an individual's cellular and humoral immunity and allows it to exert an antiviral effect

"Because patients with hematological tumors have done chemotherapy or immunotherapy, the B cells in the human body have been consumed, so the human body is not easy to produce antibodies

In the past two and a half years, Professor Ma Jun has rescued a total of 6 cases of leukemia and lymphoma patients infected with new crown, thanks to the joint research of the MDT team of hematologists and infectious disease doctors, all 6 cases have been successful, and there is no death
due to infection with new crown.

Immunocompromised patients not only make patients with blood tumors susceptible to COVID-19 infection, but also have higher
severe and case fatality rates in patients with blood tumors after infection.

According to relevant international research statistics, lymphoma and myeloma patients account for 42.
3%
of the severe disease rate.

A multicenter retrospective cohort study in Italy found that patients with hematological tumors, especially elderly patients, had a poor prognosis and a mortality rate of about 37.
6%.

This also requires clinical increased attention to
immunocompromised populations.

Usually, the immune response population refers to the treatment required because of the disease or the disease itself, so that the human body can not produce the required protective antibodies, and then produce a state of immune insufficiency, mainly including three types of people: First, patients receiving tumor radiotherapy and chemotherapy, such groups will suppress immunity due to anti-tumor therapy; Second, immunosuppressed patients, including people with systemic lupus erythematosus and rheumatoid arthritis, should use hormones for a long time, and hormones themselves will also inhibit immune function; The third is the postoperative population of organ transplantation, such as bone marrow transplantation, kidney transplantation, etc.
, these groups should use anti-rejection drugs, so that the body's immune system will not reject the transplanted organs, so that such people will not have a normal immune response
.

In addition, studies have shown that about 15%-25% of patients with hematological tumors may not have effective antibodies produced by their own bodies after receiving the new crown vaccine, and the different stages of treatment, treatment regimens, and timing of vaccination may also affect the level
of immune response they produce after vaccination.

Therefore, a considerable number of patients with hematological tumors, such as those who are in intensive therapy, immunosuppressant therapy, hematopoietic stem cell transplantation, or other underlying diseases that are contraindicated to vaccination, need additional supplementary preventive measures to help patients with blood tumors resist the new crown virus
.

"We can have exogenous antibodies to protect the blood tumor patient population
.
"
Professor Ma Jun explained that the study confirmed that after the monoclonal antibody is directly injected into the body, it can provide antibodies that cannot be produced by itself, and quickly form protection after the input, which is a passive immunity
.

"At present, in addition to hematological tumor patients, it is also necessary to pay attention to people with unsound immune function, such as the elderly over 60 years old, cancer patients and people with weak chronic diseases, who may have a poor prognosis after infection with the new crown, and this part of the population can also use neutralizing antibodies to prevent the new crown and further improve the protection
.
"
Professor Ma Jun further explained
.

On April 5, 2022, the National Comprehensive Cancer Network released the NCCN COVID-19 Vaccination Guide for People With Cancer, which recommends that cancer patients be fully vaccinated, and that patients with hematological tumors, as a high-risk group of severe COVID-19 patients, can give priority to the use of monoclonal antibody drugs
that have been proven to have preventive efficacy.

Ma Jun, Professor

• Chief Physician, Professor, Doctoral Supervisor

• Director of Harbin Institute of Hematology and Oncology

• Chairman of the Supervisory Board of the Chinese Society of Clinical Oncology (CSCO).
  

• Vice Chairman of the Asian Society of Clinical Oncology

• Chairman of the Leukemia Expert Committee of the Chinese Society of Clinical Oncology

• National Health Commission Capacity Building and Continuing Education Center Lymphoma

• Leader of the expert group for specialized construction projects

• Honorary Consultant of the Nursing Group of the Lymphoma Expert Committee of the Chinese Society of Clinical Oncology

• In 1979, he went to the Faculty of Medicine of the University of Tokyo in Japan to study, and has been committed to the diagnosis and treatment of benign and malignant diseases of the blood system, especially for the treatment of leukemia and lymphoma
  .
  
  In 1982, the first in vitro multi-energy hematopoietic progenitor cell culture system was established in China to fill the domestic gap
  .
  
  Since 1983, more than 1,200 cases of acute promyelocytic leukemia have been treated with tretinoin and arsenic trioxide sequential therapy, and the 10-year disease-free survival rate is 85%, reaching the international advanced level
  .
  
  He has published more than 200 papers and more than 40 monographs in domestic and foreign journals, and won 20 national, provincial and municipal science and technology awards
  .
  
  He has undertaken 8 national 863 major scientific research projects and 25 provincial and municipal scientific research projects
  .
  
  

Source: 21st Century Business Herald

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