Treating Acute Leukemia During the COVID-19 Pandemic in an Environment With Limited Resources: A Multicenter Experience in Four Latin American Countries.

Autor:	Demichelis-Gómez R; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico., Alvarado-Ibarra M; Centro Médico Nacional 20 de noviembre, ISSSTE, Mexico City, Mexico., Vasquez-Chávez J; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru., Delgado-López N; Hospital de Especialidades, Centro Médico Nacional siglo XXI, Mexico City, Mexico., Gómez-Cortés C; Hospital de Especialidades, Centro Médico Nacional siglo XXI, Mexico City, Mexico., Espinosa-Bautista K; Instituto Nacional de Cancerología, Mexico City, Mexico., Cooke-Tapia A; Complejo Hospitalario Doctor Arnulfo Arias Madrid, Panama, Panama., Milán-Salvatierra A; Hospital Juárez de México, Mexico City, Mexico., Gómez-De León A; Universidad Autónoma de Nuevo Léon, Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico., Lee-Tsai YL; Hospital General San Juan de Dios de Guatemala, Guatemala., Rosales-López D; Instituto Guatemalteco de Seguridad Social, Guatemala City, Guatemala., Cabrera-García Á; Hospital Regional de Alta Especialidad de Ixtapaluca, Estado de México, Mexico., Amador-Medina F; Hospital Regional de Alta Especialidad del Bajío, León, Mexico., Córdoba-Ramírez A; Centro de Hematología y Medicina Interna Puebla, Puebla, Mexico., Murrieta-Álvarez I; Centro de Hematología y Medicina Interna Puebla, Puebla, Mexico., Solís-Poblano JC; Hospital de Especialidades CMN 'Manuel Ávila Camacho,' IMSS Puebla, Mexico., Apodaca-Chávez E; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico., Rangel-Patiño J; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico., Álvarez-Vera JL; Centro Médico Nacional 20 de noviembre, ISSSTE, Mexico City, Mexico., Arana-Luna L; Centro Médico Nacional 20 de noviembre, ISSSTE, Mexico City, Mexico., De la Peña-Celaya JA; Centro Médico Nacional 20 de noviembre, ISSSTE, Mexico City, Mexico., Espitia-Ríos ME; Centro Médico Nacional 20 de noviembre, ISSSTE, Mexico City, Mexico., Hernández-Ruiz E; Centro Médico Nacional 20 de noviembre, ISSSTE, Mexico City, Mexico., Pérez-Zúñiga JM; Centro Médico Nacional 20 de noviembre, ISSSTE, Mexico City, Mexico., Peña-López E; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru., González-Rivera R; Hospital de Especialidades, Centro Médico Nacional siglo XXI, Mexico City, Mexico., García-Leyva MF; Instituto Nacional de Cancerología, Mexico City, Mexico., Tejeda-Romero M; Hospital Juárez de México, Mexico City, Mexico., Cruz-Rico J; Hospital Juárez de México, Mexico City, Mexico., Balderas-Delgado C; Hospital Regional de Alta Especialidad de Ixtapaluca, Estado de México, Mexico., Ruíz-Argüelles GJ; Centro de Hematología y Medicina Interna Puebla, Puebla, Mexico., Gómez-Almaguer D; Universidad Autónoma de Nuevo Léon, Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico.
Jazyk:	angličtina
Zdroj:	JCO global oncology [JCO Glob Oncol] 2021 Apr; Vol. 7, pp. 577-584.
DOI:	10.1200/GO.20.00620
Abstrakt:	Purpose: The COVID-19 pandemic is a colossal challenge for global health; nonetheless, specific subgroups face considerably higher risks for infection and mortality. Among patients with malignant diseases, those with hematologic neoplasms are at a higher risk for poor outcomes. The objective of this study was to register treatment modifications associated with the COVID-19 pandemic and their short-term consequences in Latin America. Methods: Multicenter, prospective, observational, cohort study including patients older than 14 years from 14 centers in four countries (Mexico, Peru, Guatemala, and Panama) who had a confirmed diagnosis of acute leukemia, and who were undergoing active treatment since the first COVID-19 case in each country until the cutoff on July 15, 2020. Results: We recruited 635 patients. Treatment modifications because of the COVID-19 pandemic were reported in 40.8% of cases. The main reason for such modifications was logistic issues (55.0%) and the most frequent modification was chemotherapy delay (42.0%). A total of 13.1% patients developed COVID-19 disease, with a mortality of 37.7%. Several factors were identified as independently associated with mortality, including a diagnosis of acute myeloid leukemia (odds ratio 2.38 [95% CI, 1.47 to 3.84]; P < .001), while the use of telemedicine was identified as a protective factor (odds ratio 0.36 [95% CI, 0.18 to 0.82]; P = .014). Conclusion: These results highlight the collateral damage of COVID-19 in oncology patients. Competing Interests: Roberta Demichelis-GómezHonoraria: AbbVie, Novartis, Amgen, Celgene/Bristol-Myers SquibbConsulting or Advisory Role: AbbVie, Novartis, Amgen, Celgene/Bristol-Myers Squibb, Jazz PharmaceuticalsSpeakers' Bureau: AbbVie, Novartis, Amgen, Celgene/Bristol-Myers SquibbResearch Funding: NovartisTravel, Accommodations, Expenses: AbbVie, Novartis Jule Vasquez-ChávezTravel, Accommodations, Expenses: Janssen Nancy Delgado-LópezConsulting or Advisory Role: Amgen, PfizerSpeakers' Bureau: Bristol-Myers Squibb (Mexico), Novartis Ana Cooke-TapiaTravel, Accommodations, Expenses: Janssen Andrés Gómez-De LeónHonoraria: Novartis, AbbVieConsulting or Advisory Role: AstraZeneca, Sanofi/Aventis Luara Arana-LunaSpeakers' Bureau: Amgen, NovartisTravel, Accommodations, Expenses: Teva José Antonio De la Peña-CelayaConsulting or Advisory Role: Janssen-Cilag, RocheSpeakers' Bureau: Janssen-Cilag, Roche, Novartis, Asofarma, Celgene/Bristol-Myers SquibbTravel, Accommodations, Expenses: Roche Eleazar Hernández-RuizSpeakers' Bureau: RocheResearch Funding: Bristol-Myers Squibb, Amgen, Roche Juan Manuel Pérez-ZúñigaConsulting or Advisory Role: Roche, Takeda, Bayer, Sanofi, Novo NordiskSpeakers' Bureau: Roche, Bristol-Myers Squibb (Mexico), Novartis, AmgenResearch Funding: AstraZeneca David Gómez-AlmaguerConsulting or Advisory Role: Celgene, Janssen, TakedaSpeakers' Bureau: Bristol-Myers Squibb (Mexico), AbbVie, Novartis, Janssen, AmgenNo other potential conflicts of interest were reported.
Databáze:	MEDLINE
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