1.Weathering the storm: COVID-19 infection in patients with hematological malignancies.
Lin-Qin WANG ; Elaine TAN SU YIN ; Guo-Qing WEI ; Yong-Xian HU ; Arnon NAGLER ; He HUANG
Journal of Zhejiang University. Science. B 2020;21(12):921-939
The coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Within a matter of months, this highly contagious novel virus has led to a global outbreak and is still spreading rapidly across continents. In patients with COVID-19, underlying chronic diseases and comorbidities are associated with dismal treatment outcomes. Owing to their immunosuppressive status, patients with hematological malignancies (HMs) are at an increased risk of infection and have a worse prognosis than patients without HMs. Accordingly, intensive attention should be paid to this cohort. In this review, we summarize and analyze specific clinical manifestations for patients with coexisting COVID-19 and HMs. Furthermore, we briefly describe customized management strategies and interventions for this susceptible cohort. This review is intended to guide clinical practice.
COVID-19/prevention & control*
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Diagnosis, Differential
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Disease Management
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Hematologic Neoplasms/virology*
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Hospitalization
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Humans
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Immunocompromised Host
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Risk Factors
2.A giant step forward: chimeric antigen receptor T-cell therapy for lymphoma.
Houli ZHAO ; Yiyun WANG ; Elaine Tan Su YIN ; Kui ZHAO ; Yongxian HU ; He HUANG
Frontiers of Medicine 2020;14(6):711-725
The combination of the immunotherapy (i.e., the use of monoclonal antibodies) and the conventional chemotherapy increases the long-term survival of patients with lymphoma. However, for patients with relapsed or treatment-resistant lymphoma, a novel treatment approach is urgently needed. Chimeric antigen receptor T (CAR-T) cells were introduced as a treatment for these patients. Based on recent clinical data, approximately 50% of patients with relapsed or refractory B-cell lymphoma achieved complete remission after receiving the CD19 CAR-T cell therapy. Moreover, clinical data revealed that some patients remained in remission for more than two years after the CAR-T cell therapy. Other than the CD19-targeted CAR-T, the novel target antigens, such as CD20, CD22, CD30, and CD37, which were greatly expressed on lymphoma cells, were studied under preclinical and clinical evaluations for use in the treatment of lymphoma. Nonetheless, the CAR-T therapy was usually associated with potentially lethal adverse effects, such as the cytokine release syndrome and the neurotoxicity. Therefore, optimizing the structure of CAR, creating new drugs, and combining CAR-T cell therapy with stem cell transplantation are potential solutions to increase the effectiveness of treatment and reduce the toxicity in patients with lymphoma after the CAR-T cell therapy.
Cell- and Tissue-Based Therapy
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Humans
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Immunotherapy, Adoptive
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Lymphoma/therapy*
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Receptors, Antigen, T-Cell
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Receptors, Chimeric Antigen