COVID-19 у пациентов с острыми лейкозами: опыт 3 лет пандемии

Пациенты с острыми лейкозами являются одной из наиболее уязвимых групп в отношении риска заражения SARS-CoV-2 и тяжелого течения коронавирусной инфекции. На протяжении первых 2 лет пандемии смертность пациентов с острыми лейкозами составляла 11-48 % в зависимости от типа лейкоза и лишь в 2022 г. Достигла популяционных значений. Факторами риска тяжелого течения COVID-19 у пациентов с острыми лейкозами являются пожилой возраст, сопутствующая кардиальная патология, метаболический синдром, а также отсутствие ремиссии острого лейкоза. Химиотерапевтическое лечение, проведенное за месяц до госпитализации с диагнозом COVID-19, показало статистическую значимость во влиянии на госпитальную летальность лишь в группе пациентов с острыми миелоидными лейкозами. Несмотря на это, международным медицинским сообществом рекомендовано отложить начало химиотерапии до полного регресса клинических симптомов коронавирусной инфекции и получения отрицательного результата теста на SARS-CoV-2 для всех типов лейкозов. В настоящее время наиболее оптимальной тактикой является профилактика заражения SARS-CoV-2 с помощью вакцинации пациентов с острыми лейкозами, получающих программное противоопухолевое лечение. При недостаточном иммунологическом ответе на вакцинацию возможно использование вируснейтрализующих моноклональных антител как безопасный и эффективный метод первичной профилактики COVID-19.

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