Special considerations in the management of adult patients with acute leukaemias and myeloid neoplasms in the COVID-19 era: recommendations from a panel of international experts

Amer M Zeidan¹, Prajwal C Boddu², Mrinal M Patnaik³, Jan Philipp Bewersdorf², Maximilian Stahl⁴, Raajit K Rampal⁴, Rory Shallis², David P Steensma⁵, Michael R Savona⁶, Mikkael A Sekeres⁷, Gail J Roboz⁸, Daniel J DeAngelo⁵, Andre C Schuh⁹, Eric Padron¹⁰, Joshua F Zeidner¹¹, Roland B Walter¹², Francesco Onida¹³, Amir Fathi¹⁴, Amy DeZern¹⁵, Gabriela Hobbs¹⁴, Eytan M Stein⁴, Paresh Vyas¹⁶, Andrew H Wei¹⁷, David T Bowen¹⁸, Pau Montesinos¹⁹, Elizabeth A Griffiths²⁰, Amit K Verma²¹, Alla Keyzner²², Michal Bar-Natan²², Shyamala C Navada²², Marina Kremyanskaya²², Aaron D Goldberg⁴, Aref Al-Kali³, Mark L Heaney²³, Aziz Nazha²⁴, Huda Salman²⁵, Selina Luger²⁶, Keith W Pratz²⁶, Heiko Konig²⁷, Rami Komrokji¹⁰, Michael Deininger²⁸, Blanca Xicoy Cirici²⁹, Vijaya Raj Bhatt³⁰, Lewis R Silverman²², Harry P Erba³¹, Pierre Fenaux³², Uwe Platzbecker³³, Valeria Santini³⁴, Eunice S Wang²⁰, Martin S Tallman⁴, Richard M Stone⁵, John Mascarenhas²²

Affiliations

¹ Section of Hematology, Yale School of Medicine, Yale University, New Haven, CT, USA; Yale Comprehensive Cancer Center, Yale School of Medicine, Yale University, New Haven, CT, USA. Electronic address: amer.zeidan@yale.edu.
² Section of Hematology, Yale School of Medicine, Yale University, New Haven, CT, USA; Yale Comprehensive Cancer Center, Yale School of Medicine, Yale University, New Haven, CT, USA.
³ Department of Hematology, Mayo Clinic, Rochester, MN, USA.
⁴ Department of Hematology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
⁵ Department of Hematology, Division of Leukemia, Dana-Farber Cancer Institute, Boston, MA, USA.
⁶ Department of Hematology, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
⁷ Leukemia Program, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, OH, USA.
⁸ Department of Hematology and Oncology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, USA.
⁹ Division of Medical Oncology and Hematology, University of Toronto, Toronto, ON, Canada.
¹⁰ Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL, USA.
¹¹ Division of Hematology and Oncology, Lineberger Comprehensive Care Center, University of North Carolina, Chapel Hill, NC, USA.
¹² Division of Hematology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
¹³ Department of Hematology, IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
¹⁴ Department of Hematology, Centre for Leukemia, Massachusetts General Hospital, Boston, MA, USA.
¹⁵ Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA.
¹⁶ MRC Molecular Haematology Unit, BRC Oxford Department of Haematology, University of Oxford, Oxford, UK.
¹⁷ Department of Clinical Haematology, Alfred Hospital, Melbourne, VIC, Australia.
¹⁸ Department of Haematology, Leeds Teaching Hospitals National Health Service Trust, Leeds, UK.
¹⁹ Department of Haematology, Hospital Universitario y Politecnico La Fe, Valencia, Spain; CIBERONC, Instituto Carlos III, University of Valencia, Madrid, Spain.
²⁰ Leukemia Service, Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
²¹ Department of Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA.
²² Division of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
²³ Department of Hematology, Herbert Irving Comprehensive Care Centre, Columbia University, New York, NY, USA.
²⁴ Department of Hematology, Cleveland Clinic-Taussig Cancer Institute, Cleveland, OH, USA.
²⁵ Department of Internal Medicine, Stony Brook University Cancer Center, Stony Brook, NY, USA.
²⁶ Department of Medicine, Hematology and Oncology Division, University of Pennsylvania, Philadelphia, PA, USA.
²⁷ Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Division of Hematology and Oncology, Indiana University, Indianapolis, IN, USA.
²⁸ Huntsman Cancer Institute, Department of Medicine, Division of Hematology and Hematologic Malignancies, University of Utah, Salt Lake City, UT, USA.
²⁹ Clinical Haematology Department, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
³⁰ Fred and Pamela Buffett Cancer Center, Department of Oncology and Hematology, University of Nebraska Medical Center, Omaha, NE, USA.
³¹ Duke Cancer Institute, Department of Medicine, Division of Hematologic Malignancies and Cellular Therapies, Durham, NC, USA.
³² Department of Hematology, Hôpital St Louis, Assistance Publique-Hôpitaux de Paris, Paris, France; Department of Haematology, Paris University, Paris, France.
³³ Department of Medicine, Division of Translational Hematology, Leipzig University Hospital, Leipzig, Germany.
³⁴ Department of Medicine, University of Florence Medical School, Florence, Italy.

PMID: 32563283
PMCID: PMC7302757
DOI: 10.1016/S2352-3026(20)30205-2

Review

Special considerations in the management of adult patients with acute leukaemias and myeloid neoplasms in the COVID-19 era: recommendations from a panel of international experts

Amer M Zeidan et al. Lancet Haematol. 2020 Aug.

. 2020 Aug;7(8):e601-e612.

doi: 10.1016/S2352-3026(20)30205-2. Epub 2020 Jun 18.

Authors

Affiliations

¹ Section of Hematology, Yale School of Medicine, Yale University, New Haven, CT, USA; Yale Comprehensive Cancer Center, Yale School of Medicine, Yale University, New Haven, CT, USA. Electronic address: amer.zeidan@yale.edu.
² Section of Hematology, Yale School of Medicine, Yale University, New Haven, CT, USA; Yale Comprehensive Cancer Center, Yale School of Medicine, Yale University, New Haven, CT, USA.
³ Department of Hematology, Mayo Clinic, Rochester, MN, USA.
⁴ Department of Hematology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
⁵ Department of Hematology, Division of Leukemia, Dana-Farber Cancer Institute, Boston, MA, USA.
⁶ Department of Hematology, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
⁷ Leukemia Program, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, OH, USA.
⁸ Department of Hematology and Oncology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, USA.
⁹ Division of Medical Oncology and Hematology, University of Toronto, Toronto, ON, Canada.
¹⁰ Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL, USA.
¹¹ Division of Hematology and Oncology, Lineberger Comprehensive Care Center, University of North Carolina, Chapel Hill, NC, USA.
¹² Division of Hematology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
¹³ Department of Hematology, IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
¹⁴ Department of Hematology, Centre for Leukemia, Massachusetts General Hospital, Boston, MA, USA.
¹⁵ Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA.
¹⁶ MRC Molecular Haematology Unit, BRC Oxford Department of Haematology, University of Oxford, Oxford, UK.
¹⁷ Department of Clinical Haematology, Alfred Hospital, Melbourne, VIC, Australia.
¹⁸ Department of Haematology, Leeds Teaching Hospitals National Health Service Trust, Leeds, UK.
¹⁹ Department of Haematology, Hospital Universitario y Politecnico La Fe, Valencia, Spain; CIBERONC, Instituto Carlos III, University of Valencia, Madrid, Spain.
²⁰ Leukemia Service, Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
²¹ Department of Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA.
²² Division of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
²³ Department of Hematology, Herbert Irving Comprehensive Care Centre, Columbia University, New York, NY, USA.
²⁴ Department of Hematology, Cleveland Clinic-Taussig Cancer Institute, Cleveland, OH, USA.
²⁵ Department of Internal Medicine, Stony Brook University Cancer Center, Stony Brook, NY, USA.
²⁶ Department of Medicine, Hematology and Oncology Division, University of Pennsylvania, Philadelphia, PA, USA.
²⁷ Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Division of Hematology and Oncology, Indiana University, Indianapolis, IN, USA.
²⁸ Huntsman Cancer Institute, Department of Medicine, Division of Hematology and Hematologic Malignancies, University of Utah, Salt Lake City, UT, USA.
²⁹ Clinical Haematology Department, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
³⁰ Fred and Pamela Buffett Cancer Center, Department of Oncology and Hematology, University of Nebraska Medical Center, Omaha, NE, USA.
³¹ Duke Cancer Institute, Department of Medicine, Division of Hematologic Malignancies and Cellular Therapies, Durham, NC, USA.
³² Department of Hematology, Hôpital St Louis, Assistance Publique-Hôpitaux de Paris, Paris, France; Department of Haematology, Paris University, Paris, France.
³³ Department of Medicine, Division of Translational Hematology, Leipzig University Hospital, Leipzig, Germany.
³⁴ Department of Medicine, University of Florence Medical School, Florence, Italy.

PMID: 32563283
PMCID: PMC7302757
DOI: 10.1016/S2352-3026(20)30205-2

Abstract

The ongoing COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 is a global public health crisis. Multiple observations indicate poorer post-infection outcomes for patients with cancer than for the general population. Herein, we highlight the challenges in caring for patients with acute leukaemias and myeloid neoplasms amid the COVID-19 pandemic. We summarise key changes related to service allocation, clinical and supportive care, clinical trial participation, and ethical considerations regarding the use of lifesaving measures for these patients. We recognise that these recommendations might be more applicable to high-income countries and might not be generalisable because of regional differences in health-care infrastructure, individual circumstances, and a complex and highly fluid health-care environment. Despite these limitations, we aim to provide a general framework for the care of patients with acute leukaemias and myeloid neoplasms during the COVID-19 pandemic on the basis of recommendations from international experts.

PubMed Disclaimer

References

1. Centre for Evidence-Based Medicine Global Covid-19 case fatality rates. March 17, 2020. https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/
1. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323:1239–1242. - PubMed
1. Shallis RM, Wang R, Davidoff A, Ma X, Zeidan AM. Epidemiology of acute myeloid leukemia: recent progress and enduring challenges. Blood Rev. 2019;36:70–87. - PubMed
1. Zeidan AM, Shallis RM, Wang R, Davidoff A, Ma X. Epidemiology of myelodysplastic syndromes: why characterizing the beast is a prerequisite to taming it. Blood Rev. 2019;34:1–15. - PubMed
1. Liang W, Guan W, Chen R, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020;21:335–337. - PMC - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Special considerations in the management of adult patients with acute leukaemias and myeloid neoplasms in the COVID-19 era: recommendations from a panel of international experts

Affiliations

Special considerations in the management of adult patients with acute leukaemias and myeloid neoplasms in the COVID-19 era: recommendations from a panel of international experts

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical