It is now a known fact that the COVID-19 disease progresses more severely in elderly people and those with additional diseases. Patients with hematological cancers, especially those whose immune system is suppressed; Due to the type of chemotherapy administered, the complications of the disease and co-morbidities, there is a higher risk of contracting COVID-19 disease.
Bayındır Söğütözü Hospital Hematology and Bone Marrow Transplantation Center Section Leader, which is located in the midst of İşbank cluster companies, stating that the death rate in cancer patients who have recently received chemotherapy and whose COVID-19 PCR test is positive has reached 30% within 30 days. prof. Dr. Ali Uğur Ural underlines that for this reason, those with hematological cancer should pay more attention to the precautions.
It is known that COVID-19, which has been included in our lives since December 2019, has a more severe course especially in elderly individuals and those with additional diseases. Patients with hematological cancer, which constitutes approximately 10% of all cancers and whose defense system is suppressed, have a higher risk of contracting COVID-19 disease due to the type of chemotherapy administered, complications of the disease and comorbidities. Severe care and ventilation requirement, sepsis, cytokine dysregulation, multiple organ failure and death are observed more frequently in cancer patients with COVID-19.
Bayındır Söğütözü Hospital Hematology and Bone Marrow Transplantation Center Section Leader, which is located in the middle of İşbank cluster companies, stating that the death rate in cancer patients who have recently received chemotherapy and whose COVID-19 PCR test is positive has reached 30% within 30 days. prof. Dr. Ali Uğur Ural said, “Although hematological cancer cases have experienced COVID-19, antibody positivity is not observed even 15 days or more after symptoms due to abnormalities in lymphocyte subsets.”
CANCER TREATMENTS STRENGTHEN THE TREATMENT OF COVID-19
Bayındır Söğütözü Hospital Hematology and Bone Hospital, who stated that the administration of chemotherapy, radiotherapy, targeted therapy or immune treatments to hematological cancer cases worsens the effects of COVID-19 disease and complicates its treatment. Marrow Transplantation Center Section Leader Prof. Dr. Ali Uğur Ural said, “Leukemia and lymphoma patients with immunosuppression are more frequently diagnosed with COVID-19 due to hypogammaglobulinemia, lymphopenia, neutropenia, steroid administration, advanced age, co-existing diseases, frequent transfusions, and frequent presence in the hospital environment.”
Some of the hematological cancers do not require emergency treatment due to the course of the disease, while others require both emergency and high-dose chemotherapy, high-dose radiotherapy and even stem cell transplantation. Dr. Ali Uğur Ural said, “Therefore, problems arise in the management of hematological cancer events in the presence of COVID-19. In addition, all patients with hematological cancer – especially those with acute leukemia and stem cell transplant candidates/transplanters – apply protective measures regardless of the COVID-19 crisis, as they wear masks, pay attention to their personal hygiene, and comply with social distancing due to their illness, thus avoiding catching COVID-19. they reduce their own risk. However, along with the treatment of COVID-19 and its complications, especially curative treatments should be applied consistently in patients with hematological cancer.
THINGS TO BE CONSIDERED UNTIL THE VACCINE IS FOUND
Prof.Dr. Dr. Ali Uğur Ural listed the most appropriate approaches for hematological cancer patients in the following form, until an effective vaccine against COVID-19 is found:
– Observation of COVID-19 symptoms such as fever, difficulty in breathing, cough,
– Asymptomatic determination of carriers,
– Administering effective but not increasing morbidity chemotherapy by evaluating on a patient basis,
– Opening the chemotherapy cycles if possible,
– Providing growth factor supplement together with chemotherapies to reduce the risk of neutropenia,
– Only emergency and life-threatening Implementation of stem cell transplantation in the presence of a threatening situation,
– Follow-up of cases where stem cell transplantation cannot be performed with chemotherapy,
– Early collection and storage of stem cells from stem cell donors,
– Postponing elective processes if possible,
– Using less immunosuppressive drugs,
– Lowering blood and platelet transfusion thresholds si,
– COVID-19 PCR should definitely be sent from the patients who will be hospitalized and start treatment.
TREATMENT FORMULA IN CANCER: BONE MARROW
Prof. Dr. Ali Uğur Ural also made statements about bone marrow transplantation, which is used in hematological cancers and diseases such as aplastic anemia and thalassemia major. Saying that one of the treatment options for an important blood disease, immune system disease, cancer or genetic disease is bone marrow transplantation, Prof. Dr. Ural listed the situations in which bone marrow transplantation is performed in the following form:
To protect the healthy bone marrow from the high-dose chemoradiotherapy required in a cancerous event (autologous),
To replace the diseased cells/bone marrow with cells taken from a healthy person (allogeneic),
To correct non-functioning bone marrow,
To correct immunosuppression,
To correct abnormalities related to congenital metabolism or enzymatic system,
For reorganization of stem cells/T Cells of the patient (in the treatment of autoimmune diseases) ).
THINGS TO BE CONSIDERED BEFORE BONE MARROW TRANSPLANTATION
Stating that the things to be considered before bone marrow transplantation are similar to prevention measures from COVID-19, Prof. Dr. Ali Uğur Ural said, “Being under control of the disease or having an infection before the bone marrow transplant will affect the success of the transplant. Infection control measures should be taken into consideration before transplantation. Sick individuals should be avoided, handshakes should not be shaken, hands should be washed frequently and visits should be reduced. he said.
