SARS-CoV-2 的 Omicron 变种由于其高传染性，已迅速成为世界范围内的主导毒株，尽管它的致病性似乎比以前的毒株要低。然而，患有血液恶性肿瘤 (HM) 和 COVID-19 的个体仍然容易受到严重感染和死亡，特别是患有慢性淋巴细胞白血病 (CLL) 和接受嵌合抗原受体 T 细胞 (CAR-T) 治疗的患者。在开始化疗或免疫抑制治疗之前，血液科医生应彻底评估患者血液疾病的严重程度以及感染 SARS-CoV-2 的潜在风险。强烈建议接种疫苗和加强剂量，疫苗反应不佳的患者可能会受益于长效 COVID-19 中和单克隆抗体（例如 Evusheld）。建议尽早使用小分子抗病毒药物来治疗 HM 患者中的轻度 COVID-19，而患有严重免疫缺陷的患者可能会受益于 SARS-CoV-2 中和单克隆抗体治疗和高滴度 COVID-19 恢复期血浆 (CCP)。对于中重度病例，可给予小剂量糖皮质激素联合早期抗病毒治疗，如果病情持续或恶化，可加用细胞因子受体拮抗剂或JAK抑制剂。在血液系统恶性肿瘤的治疗中，对于CLL、急性白血病（AL）、低危骨髓增生异常综合征（MDS）优先选择延迟化疗，但如果病情进展，则需要适当调整治疗剂量和频率，避免抗CD20单克隆抗体、CAR-T和造血干细胞移植（HSCT）。患有慢性粒细胞白血病（CML）和骨髓增生性肿瘤（MPN）的患者可以继续当前的治疗。更重要的是，非药物保护措施、新疫苗和抗病毒药物的开发以及免疫功能低下人群突变的监测尤为重要。版权所有 © 2023 郭、郑和冯。

The Omicron variant of SARS-CoV-2 has rapidly become the dominant strain worldwide due to its high transmissibility, although it appears to be less pathogenic than previous strains. However, individuals with hematological malignancy (HM) and COVID-19 remain susceptible to severe infection and mortality, especially those with chronic lymphocytic leukemia (CLL) and those undergoing chimeric antigen receptor T-cell (CAR-T) treatment. Hematologists should thoroughly assess the severity of the patient's hematological disease and the potential risk of SARS-CoV-2 infection before initiating chemotherapy or immunosuppressive treatment. Vaccination and booster doses are strongly recommended and patients with a poor vaccine response may benefit from long-acting COVID-19 neutralizing monoclonal antibodies (such as Evusheld). Early use of small molecule antiviral drugs is recommended for managing mild COVID-19 in HM patients and those with severe immunodeficiency may benefit from SARS-CoV-2 neutralizing monoclonal antibody therapy and high-titer COVID-19 convalescent plasma (CCP). For moderate to severe cases, low-dose glucocorticoids in combination with early antiviral treatment can be administered, with cytokine receptor antagonists or JAK inhibitors added if the condition persists or worsens. In the treatment of hematological malignancies, delaying chemotherapy is preferable for CLL, acute leukemia (AL), and low-risk myelodysplastic syndrome (MDS), but if the disease progresses, appropriate adjustments in dosage and frequency of treatment are required, with the avoidance of anti-CD20 monoclonal antibody, CAR-T and hematopoietic stem cell transplantation (HSCT). Patients with chronic myelocytic leukemia (CML) and myeloproliferative neoplasms (MPNs) can continue current treatment. What's more, non-drug protective measures, the development of new vaccines and antiviral drugs, and monitoring of mutations in immunocompromised populations are particularly important.Copyright © 2023 Guo, Zheng and Feng.