随着COVID-19变种Omicron在中国北京的爆发，了解影响恶性血液病（HM）患者COVID-19不良结果的风险因素，可以改善临床管理。研究样本包括412例病例，主要代表急性白血病、慢性骨髓性白血病（CML）、浆细胞异常增生、淋巴瘤和慢性淋巴细胞白血病。观察到43/412（10.4％）患者发生COVID-19肺炎，22/412（5.3％）观察到严重/危重症。在86例复杂恶性疾病的病例中，17.6％（12/86）的患者发生了严重/危重COVID-19，显著高于报告中的稳定癌症患者（9/326，2.70％，p <0.001）。同样，复杂恶性疾病组有更高的死亡率（9/86，10.5％与0/326，0％，p <0.001）和30天总生存率较差（74.2％与100.0％，p <0.0001）相比，稳定癌症队列。总体而言，有9名患者（2.2％）死亡。死亡的主要原因是4名患者的恶性血液病进展和5名患者的COVID-19和恶性血液病的综合作用。在多变量分析中，65岁以上、合并病和复杂的恶性疾病与HM患者的严重/危重COVID-19相关。本研究揭示了COVID-19 HM患者不良结局的真相，其中主要原因是复杂的恶性肿瘤病变。 © 2023英国血液学协会和约翰·威利子夫有限公司。

As the COVID-19 variant Omicron surge in Beijing, China, a better understanding of risk factors for adverse outcomes may improve clinical management in patients with haematological malignancies (HM) diagnosed with COVID-19. The study sample includes 412 cases, mainly represented by acute leukaemia, chronic myeloid leukaemia (CML), plasma cell disorders and lymphoma and chronic lymphocytic leukaemia. COVID-19 pneumonia was observed in 10.4% (43/412) of patients, and severe/critical illness was observed in 5.3% (22/412). Among the 86 cases with advanced malignancies, 17.6% (12/86) of patients developed severe/critical COVID-19, which was significantly higher than reported in patients with stable malignancies (9/326, 2.70%, p < 0.001). Similarly, the advanced malignancy cohort had a higher mortality rate (9/86, 10.5% vs. 0/326, 0%, p < 0.001) and a poor 30-day overall survival (OS) compared with the stable malignancy cohort (74.2% vs. 100.0%, p < 0.0001). Overall, nine patients (2.2%) died. The primary cause of death was progressive HM in four patients and a combination of both COVID-19 and HM in five patients. In the multivariable analysis, over 65 years of age, comorbidities and advanced malignancy were correlated with severe/critical COVID-19 in HM patients. This study sheds light on the poor outcomes among COVID-19 HM patients with the leading cause of advanced malignancy.© 2023 British Society for Haematology and John Wiley & Sons Ltd.