Evidence-based management of COVID-19 in cancer patients: Guideline by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO)

Nicola Giesen¹, Rosanne Sprute², Maria Rüthrich³, Yascha Khodamoradi⁴, Sibylle C Mellinghoff², Gernot Beutel⁵, Catherina Lueck⁵, Michael Koldehoff⁶, Marcus Hentrich⁷, Michael Sandherr⁸, Michael von Bergwelt-Baildon⁹, Hans-Heinrich Wolf¹⁰, Hans H Hirsch¹¹, Bernhard Wörmann¹², Oliver A Cornely², Philipp Köhler², Enrico Schalk¹³, Marie von Lilienfeld-Toal³

Affiliations

¹ Department of Haematology and Oncology, Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany. Electronic address: nicola.giesen@med.uni-heidelberg.de.
² University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Center for Integrated Oncology (CIO ABCD), German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany; University of Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.
³ Department of Haematology and Medical Oncology, Clinic for Internal Medicine II, University Hospital Jena, Jena, Germany; Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany.
⁴ Department of Internal Medicine, Infectious Diseases, Goethe University Frankfurt, Frankfurt Am Main, Germany.
⁵ Department for Haematology, Haemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany; Working Party Intensive Care in Haematologic and Oncologic Patients (iCHOP) of the German Society of Haematology and Medical Oncology (DGHO).
⁶ Working Party Intensive Care in Haematologic and Oncologic Patients (iCHOP) of the German Society of Haematology and Medical Oncology (DGHO); Department of Bone Marrow Transplantation, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
⁷ Department of Medicine III - Haematology/Oncology, Red Cross Hospital, Munich, Germany.
⁸ Specialist Clinic for Haematology and Oncology, Medical Care Center Penzberg, Penzberg, Germany.
⁹ Working Party Intensive Care in Haematologic and Oncologic Patients (iCHOP) of the German Society of Haematology and Medical Oncology (DGHO); Department of Internal Medicine III, LMU University Hospital, DKTK Partner Site Munich, BZKF Partner Site Munich, CCC-Munich, Munich, Germany.
¹⁰ Department of Haematology, Oncology and Haemostaseology, Internal Medicine III, Südharzklinikum, Nordhausen, Germany.
¹¹ Transplantation & Clinical Virology, Department Biomedicine (Haus Petersplatz), University of Basel, Basel, Switzerland; Clinical Virology, Laboratory Medicine, University Hospital Basel, Basel, Switzerland; Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Basel, Switzerland.
¹² Division of Haematology, Oncology and Tumor Immunology, Department of Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.
¹³ Working Party Intensive Care in Haematologic and Oncologic Patients (iCHOP) of the German Society of Haematology and Medical Oncology (DGHO); Department of Haematology and Oncology, Medical Center, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.

PMID: 33068941
PMCID: PMC7505554
DOI: 10.1016/j.ejca.2020.09.009

Evidence-based management of COVID-19 in cancer patients: Guideline by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO)

Nicola Giesen et al. Eur J Cancer. 2020 Nov.

. 2020 Nov:140:86-104.

doi: 10.1016/j.ejca.2020.09.009. Epub 2020 Sep 21.

Authors

Affiliations

¹ Department of Haematology and Oncology, Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany. Electronic address: nicola.giesen@med.uni-heidelberg.de.
² University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Center for Integrated Oncology (CIO ABCD), German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany; University of Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.
³ Department of Haematology and Medical Oncology, Clinic for Internal Medicine II, University Hospital Jena, Jena, Germany; Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany.
⁴ Department of Internal Medicine, Infectious Diseases, Goethe University Frankfurt, Frankfurt Am Main, Germany.
⁵ Department for Haematology, Haemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany; Working Party Intensive Care in Haematologic and Oncologic Patients (iCHOP) of the German Society of Haematology and Medical Oncology (DGHO).
⁶ Working Party Intensive Care in Haematologic and Oncologic Patients (iCHOP) of the German Society of Haematology and Medical Oncology (DGHO); Department of Bone Marrow Transplantation, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
⁷ Department of Medicine III - Haematology/Oncology, Red Cross Hospital, Munich, Germany.
⁸ Specialist Clinic for Haematology and Oncology, Medical Care Center Penzberg, Penzberg, Germany.
⁹ Working Party Intensive Care in Haematologic and Oncologic Patients (iCHOP) of the German Society of Haematology and Medical Oncology (DGHO); Department of Internal Medicine III, LMU University Hospital, DKTK Partner Site Munich, BZKF Partner Site Munich, CCC-Munich, Munich, Germany.
¹⁰ Department of Haematology, Oncology and Haemostaseology, Internal Medicine III, Südharzklinikum, Nordhausen, Germany.
¹¹ Transplantation & Clinical Virology, Department Biomedicine (Haus Petersplatz), University of Basel, Basel, Switzerland; Clinical Virology, Laboratory Medicine, University Hospital Basel, Basel, Switzerland; Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Basel, Switzerland.
¹² Division of Haematology, Oncology and Tumor Immunology, Department of Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.
¹³ Working Party Intensive Care in Haematologic and Oncologic Patients (iCHOP) of the German Society of Haematology and Medical Oncology (DGHO); Department of Haematology and Oncology, Medical Center, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.

PMID: 33068941
PMCID: PMC7505554
DOI: 10.1016/j.ejca.2020.09.009

Abstract

Since its first detection in China in late 2019 the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated infectious disease COVID-19 continue to have a major impact on global healthcare and clinical practice. Cancer patients, in particular those with haematological malignancies, seem to be at an increased risk for a severe course of infection. Deliberations to avoid or defer potentially immunosuppressive therapies in these patients need to be balanced against the overarching goal of providing optimal antineoplastic treatment. This poses a unique challenge to treating physicians. This guideline provides evidence-based recommendations regarding prevention, diagnostics and treatment of SARS-CoV-2 infection and COVID-19 as well as strategies towards safe antineoplastic care during the COVID-19 pandemic. It was prepared by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO) by critically reviewing the currently available data on SARS-CoV-2 and COVID-19 in cancer patients applying evidence-based medicine criteria.

Keywords: COVID-19; Cancer; Coronavirus; Guideline; Haematological malignancy; SARS-CoV-2.

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Conflict of interest statement

Conflict of interest statement The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: N.G. reports personal fees from MSD, personal fees from Roche, personal fees from Pfizer, grants from BMS, grants from Karyopharm, outside the submitted work. S.C.M. reports grants from University of Cologne (KoelnFortune), grants from DMyKG, grants from DZIF, and personal fees from Octapharma, outside the submitted work. Y.K. reports personal fees from GILEAD Sciences, grants, personal fees and other from MSD SHARP & DOHME, outside the submitted work. G.B. reports grants from The German Federal Ministry of Research and Education, grants from The German Federal Ministry of Health, personal fees from Jazz Pharmaceuticals, personal fees from MSD, and personal fees from NewConceptOncology, outside the submitted work. C.L. reports non-financial support from Jazz Pharmaceuticals and non-financial support from Neovii, outside the submitted work. M.H. reports personal fees from Amgen, personal fees from Janssen, personal fees from Celgene, personal fees from Sanofi, and personal fees from Takeda, outside the submitted work. M.B.B. reports being the principal investigator (PI) of the COVACTA Trial at LMU. O.A.C. supported from the German Federal Ministry of Research and Education; funded from the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under Germany's Excellence Strategy-CECAD, EXC 2030–390661388; research grants from Actelion, Amplyx, Astellas, Basilea, Cidara, Da Volterra, F2G, Gilead, Janssen, Medicines Company, Melinta, Merck/MSD, Octapharma, Pfizer, Scynexis; being a consultant to Actelion, Allecra, Amplyx, Astellas, Basilea, Biosys, Cidara, Da Volterra, Entasis, F2G, Gilead, IQVIA, Matinas, MedPace, Menarini, Merck/MSD, Mylan, Nabriva, Noxxon, Octapharma, Paratek, Pfizer, PSI, Roche Diagnostics, Scynexis, and Shionogi; and lecture honoraria from Astellas, Basilea, Gilead, Grupo Biotoscana, Merck/MSD and Pfizer. P.K. reports non-financial scientific grants from Miltenyi Biotec GmbH, Bergisch Gladbach, Germany, and the Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne, Germany and lecture honoraria from or being advisor to Akademie für Infektionsmedizin e.V., Astellas Pharma, Gilead Sciences GPR Academy Ruesselsheim, MSD Sharp & Dohme GmbH, Noxxon N.V., and University Hospital, LMU Munich, outside the submitted work. M.v.L.T. reports personal fees from Celgene, Gilead, Chugai, Janssen, Novartis, Amgen, Takeda, BMS, Medac, Oncopeptides, Merck, CDDF, Pfizer, 4DPharma, and Shionogi and grants from BMBF, Deutsche Jose Carreras Leukämie-Stiftung, IZKF Jena, DFG, Novartis, Gilead, Deutsche Krebshilfe, Celgene, outside the submitted work. All other authors have nothing to disclose.

References

1. Guan W.J., Ni Z.Y., Hu Y., Liang W.H., Ou C.Q., He J.X., et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708–1720. - PMC - PubMed
1. Zhu N., Zhang D., Wang W., Li X., Yang B., Song J., et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727–733. - PMC - PubMed
1. Giacomelli A., Pezzati L., Conti F., Bernacchia D., Siano M., Oreni L., et al. Self-reported olfactory and taste disorders in SARS-CoV-2 patients: a cross-sectional study. Clin Infect Dis. 2020;71(15):889–890. - PMC - PubMed
1. Huang C., Wang Y., Li X., Ren L., Zhao J., Hu Y., et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506. - PMC - PubMed
1. Tobin M.J., Laghi F., Jubran A. Why COVID-19 silent hypoxemia is baffling to physicians. Am J Respir Crit Care Med. 2020;202(3):356–360. - PMC - PubMed

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Evidence-based management of COVID-19 in cancer patients: Guideline by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO)

Affiliations

Evidence-based management of COVID-19 in cancer patients: Guideline by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO)

Authors

Affiliations

Abstract

Conflict of interest statement

References

MeSH terms

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LinkOut - more resources

Full Text Sources

Medical

Miscellaneous