摘要
目的分析新冠疫情城市封控期间多发性骨髓瘤(MM)患者的治疗管理方式及疗效转归。方法回顾性纳入2022年3月28日至6月1日上海市封控期间复旦大学附属中山医院血液科在治的267例MM患者。采集基线临床数据和该期间患者的治疗管理信息,评估对比城市封控前后患者的疗效。结果267例MM患者中,161例为本地户籍,106例为外地户籍。77.0%和16.1%的本地患者分别在我院门诊及病房治疗,76.4%的外地患者于当地医院治疗。指导治疗和随访途径包括微信(90.0%)、电话(9.0%)等联系方式。封控期间70.8%的患者未调整治疗方案;25.1%的患者用药间隔延长,主要为静脉注射达雷妥尤单抗和皮下注射硼替佐米用药频次的减低;4.1%的患者更换了治疗方案,主要原因为疾病进展;7例(2.6%)患者因新冠感染暂停治疗。与全口服药方案相比,更多含注射药方案治疗的患者延长了用药间隔(37.0%vs10.8%)。对比183例可评估患者封控前后的疗效,发现94.5%的患者解封后疗效进步或维持已获得最佳疗效。结论疫情防控常态化背景下,早期对MM患者进行科普教育、提高门诊治疗比例、对合适患者采用全口服药方案及应用新型社交媒体实施随访管理是应对疫情及突发封控事件的有效策略。
Objective To analyze management strategies and therapeutic responses of patients with multiple myeloma(MM)during COVID-19 lockdown.Methods Baseline clinical data and management information of 267 patients diagnosed with MM treated at Zhongshan Hospital,Fudan University during Shanghai lockdown from March 28 to June 1,2022,were retrospectively analyzed.Responses before and after lockdown were evaluated and compared.Results 161 native and 106 nonnative MM patients were included.77.0%and 16.1%of native patients came to outpatient and inpatient clinic of our hospital,respectively.76.4%of non-native patients went to local hospital for treatment.Follow-up was mostly completed via WeChat(90.0%)or telephone(9.0%).During lockdown,70.8%of the patients continued treatment with the original regimen.25.1%of the patients extended treatment interval,mainly lowering the frequency of intravenous daratumumab and subcutaneous bortezomib injection.Due to disease progression,4.1%of the patients changed treatment regimens.Besides,7 patients discontinued treatment due to COVID-19infection,accounting for 2.6%of all patients.In contrast to a fully oral treatment combination,more patients administered with injection-containing regimen extended treatment intervals(37.0%vs 10.8%).After comparing responses of 183 evaluable patients before and after the city lockdown,found that 94.5%of patients achieved better response or maintained the best response achieved.Conclusion Considering the virus susceptibility related to immunodeficiency in MM patients as well as less accessibility to hospitalization during COVID-19 epidemic,effective management of MM patients in the context of regular epidemic prevention and control remains an important challenge.Providing early patient education,increasing the proportion of outpatient treatment,eliciting fully oral regimens for appropriate patients,and performing follow-up management via new medium may become effective coping strategies against emergency lockdown.
作者
杨雪
承璐雅
陈晨
柯杨
顾史洋
施淼颉
张雪皎
高如攀
陈菲菲
刘澎
YANG Xue;CHENG Lu-ya;CHEN Chen;KE Yang;GU Shi-yang;SHI Miao-jie;ZHANG Xue-jiao;GAO Ru-pan;CHEN Fei-fei;LIU Peng(Department of Hematology,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
出处
《中国临床医学》
2022年第6期945-949,共5页
Chinese Journal of Clinical Medicine
基金
上海市自然科学基金(22ZR1411400)。
