Patients with hematological cancer, especially those whose immune system is suppressed; The type of chemotherapy applied carries a higher risk of getting Covid-19 disease due to the complications and accompanying diseases of the disease.
The recently had chemotherapy and Covidien-19 PCR test indicates the death rate in the positive emerging cancer patients that there are up to 30% within 30 days, Turkey Isbank Group companies among the flourishing Söğütözü Hospital Hematology and Bone Marrow Transplantation Center Department Head Dr. Ali Uğur Ural underlines that those with hematological cancer should pay more attention to the precautions.
It is known that COVID-2019, which has been included in our lives since December 19, has a more severe course especially in elderly people and those with additional diseases. Hematological cancer patients, which constitute about 10% of all cancers and whose defense system is suppressed, have a higher risk of getting COVID-19 disease due to the type of chemotherapy applied, complications of the disease and coexisting diseases. In cancer patients with COVID-19, the need for intensive care and ventilation, sepsis, cytokine regulation disorder, multi-organ failure and death are more common.
The recently had chemotherapy and Covidien-19 PCR test indicates the death rate in the positive emerging cancer patients that there are up to 30% within 30 days, Turkey Isbank Group companies among the flourishing Söğütözü Hospital Hematology and Bone Marrow Transplantation Center Department Head Dr. Ali Uğur Ural said, "Although cases with hematological cancer have passed COVID-19, antibody positivity is not observed even 15 days or later after symptoms due to abnormalities in lymphocyte subgroups."
CANCER TREATMENTS STRENGTHEN COVID-19 TREATMENT
Prof. Dr. Ali Uğur Ural said, "Immune-suppressed leukemia and lymphoma patients are more likely to get COVID-19 due to hypogammaglobulinemia, lymphopenia, neutropenia, steroid administration, advanced age, co-existing diseases, frequent transfusions, and frequent presence in the hospital environment."
Stating that some of the hematological cancers do not require urgent treatment due to the course of the disease, some require both urgent 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 cases in the presence of COVID-19. In addition, all patients with hematologic cancer - especially those with acute leukemia and stem cell transplant candidates / transplant - use masks, pay attention to their personal hygiene and observe social distance due to their illnesses, so they apply protective measures regardless of the COVID-19 crisis, thus catching COVID-19. they lower their risk themselves. However, with the treatment of COVID-19 and its complications, especially curative treatments should be applied in a balanced way in patients with hematologic cancer, ”he said.
WHAT SHOULD BE CONSIDERED UNTIL THE VACCINE IS FOUND
prof. Dr. Ali Ugur Ural, Until an effective vaccine against COVID-19 is found, he listed the most appropriate approaches for hematological cancer patients as follows:
- Observation of COVID-19 symptoms such as fever, respiratory distress, cough,
- Identifying carriers that do not show any symptoms,
- Applying effective but not increasing morbidity chemotherapy by evaluating on patient basis,
- Opening chemotherapy cure intervals if possible,
- Providing growth factor support together with chemotherapies to reduce the risk of neutropenia,
- Application of stem cell transplantation only in the presence of an emergency and life-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 procedures, if possible,
- Using less immunosuppressive drugs,
- Lowering blood and platelet transfusion thresholds,
- COVID-19 PCR must be sent to patients who will be hospitalized.
TREATMENT METHOD IN CANCER: BONE MARROW
prof. Dr. Ali Ugur Ural, He also made explanations about bone marrow transplantation used in hematological cancers and diseases such as aplastic anemia and thalassemia major. One of the treatment options for a serious blood disease, immune system disease, cancer or genetic disease is bone marrow transplantation. prof. Dr. Ural, He listed the situations in which bone marrow transplantation was performed as follows:
- To protect healthy bone marrow from high dose chemoradiotherapy required in a cancer case (autologous),
- To replace diseased cells / bone marrow with cells from intact person (allogeneic),
- To fix bone marrow that is not working,
- To restore immunosuppression,
- To correct abnormalities related to inborn metabolism or enzymatic system,
- For the rearrangement of patient's own stem cells / T Cells (in the treatment of autoimmune diseases).
WHAT TO CONSIDER BEFORE BONE MARROW TRANSPLANTATION
Stating that the things to be considered before bone marrow transplant are similar to the protection measures from COVID-19, Prof. Dr. Ali Uğur Ural said, “The fact that the disease is under control or the infection before the bone marrow transplant will affect the success of the transplant. Infection control measures should be considered before transplantation. Patients should be avoided, hands should not be shaken, their hands should be washed frequently and their visits should be reduced. " he spoke.