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.
Purpose
To ascertain the risk factors and prevalence of non-infectious diarrhea among participants with multiple myeloma who treated with chimeric antigen receptor T-cell immunotherapy.
Methods
This study enrolled 88 patients with multiple myeloma who received chimeric antigen receptor T-cell immunotherapy at one tertiary general hospital in China. Participants were categorized into diarrhea subgroup and non-diarrhea subgroup according to the occurrence of diarrhea. Demographic data and self-reported measurements and planning were obtained from questionnaires and clinical data from hospital databases.
Results
In total, 50 patients suffered from non-infectious diarrhea, with the prevalence of 56.8%. Multiple logistic regression analysis showed that severe cytokine release syndrome (OR = 5.980), underlying diseases (OR = 4.184), previous treatment lines ≥ 6 (OR = 6.292) were prominent hazardous factors for non-infectious diarrhea (p < 0.05).
Conclusion
The incidence rate of non-infectious diarrhea in patients with multiple myeloma after CAR-T therapy was at a high level. Severe cytokine release syndrome, previous treatment lines ≥ 6 and the underlying diseases were important predictors for non-infectious diarrhea. Medical staff should early evaluate these major factors to reduce the risk of diarrhea (184 words).
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