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COVID and Cancer: A Complete 3D Advanced Radiological CT-Based Analysis to Predict the Outcome. Cancers (Basel) 2023; 15:cancers15030651. [PMID: 36765610 PMCID: PMC9913442 DOI: 10.3390/cancers15030651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Cancer patients infected with COVID-19 were shown in a multitude of studies to have poor outcomes on the basis of older age and weak immune systems from cancer as well as chemotherapy. In this study, the CT examinations of 22 confirmed COVID-19 cancer patients were analyzed. METHODOLOGY A retrospective analysis was conducted on 28 cancer patients, of which 22 patients were COVID positive. The CT scan changes before and after treatment and the extent of structural damage to the lungs after COVID-19 infection was analyzed. Structural damage to a lung was indicated by a change in density measured in Hounsfield units (HUs) and by lung volume reduction. A 3D radiometric analysis was also performed and lung and lesion histograms were compared. RESULTS A total of 22 cancer patients were diagnosed with COVID-19 infection. A repeat CT scan were performed in 15 patients after they recovered from infection. Most of the study patients were diagnosed with leukemia. A secondary clinical analysis was performed to show the associations of COVID treatment on the study subjects, lab data, and outcome on mortality. It was found that post COVID there was a decrease of >50% in lung volume and a higher density in the form of HUs due to scar tissue formation post infection. CONCLUSION It was concluded that COVID-19 infection may have further detrimental effects on the lungs of cancer patients, thereby, decreasing their lung volume and increasing their lung density due to scar formation.
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Alian S, Ahangarkani F, Boskabadi SJ, Kargar-Soleimanabad S, Delavarian L, Pakzad A. Mucormycosis, one month after recovery from COVID-19: A case report. Ann Med Surg (Lond) 2022; 78:103911. [PMID: 35693105 PMCID: PMC9166249 DOI: 10.1016/j.amsu.2022.103911] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/28/2022] [Accepted: 06/02/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction and importance: There are increasing case reports of mucormycosis in patient with coronavirus disease 2019 (Covid-19). Herein, we describe the case of mucormycosis after recovery from Covid-19. Case presentation The patient was a 73 years old woman with a history of chronic kidney disease, diabetes mellitus, hypertension, and dyslipidemia that referred to the emergency department with clinical presentation of Covid-19. On the third day of admission, the Covid-19 PCR test was negative, but the patient presented headache and pain in her upper jaw. Physical examination showed fever, erythema, and tenderness in the right cheek. Emergency biopsy and culture from sinus by subsection to mucormycosis conducted. and the diagnosis of mucormycosis was confirmed by the positive result of biopsy and culture. Despite anti-fungal treatment with Amphotericin B, patient developed severe diarrhea and became hemodynamically unstable. In the stool analysis, Strongyloides stercoralis was reported. Unfortunately, patient was expired on day thirty-two of this admission. Clinical discussion Mucormycosis is a dangerous infection, and its rapid diagnosis is so important. On the other hand, Covid-19 may associated with many nonspecific sign and symptoms. These finding may overlap with other infections. In patients with prolonged mucormycosis infection, the development of strongyloidiasis should not be neglected. A single dose of ivermectin as strongyloidiasis prophylaxis should be given if the duration of the illness is prolonged. Conclusion Clinicians should consider mucormycosis and its complications after Covid-19 treatment in diabetic and immunocompromised patients. COVID-19 may be associated with bacterial or fungal co-infections. Nonspecific sign and symptoms of COVID-19, may overlap with other infections. Mucormycosis may occur following COVID-19, especially in patients with risk factors. We report a case of mucormycosis, one month after recovery from COVID-19 in a patient with poor diabetic control.
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Affiliation(s)
- Shahriar Alian
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Ahangarkani
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyyed Javad Boskabadi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Saeed Kargar-Soleimanabad
- Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Leila Delavarian
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Azalia Pakzad
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
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3
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Gengenbach L, Graziani G, Reinhardt H, Rösner A, Braun M, Möller MD, Greil C, Wäsch R, Engelhardt M. Choosing the Right Therapy for Patients with Relapsed/Refractory Multiple Myeloma (RRMM) in Consideration of Patient-, Disease- and Treatment-Related Factors. Cancers (Basel) 2021; 13:4320. [PMID: 34503130 PMCID: PMC8430818 DOI: 10.3390/cancers13174320] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/13/2021] [Accepted: 08/24/2021] [Indexed: 02/02/2023] Open
Abstract
Treatment of relapsed/refractory multiple myeloma (RRMM) is more complex today due to the availability of novel therapeutic options, mostly applied as combination regimens. immunotherapy options have especially increased substantially, likewise the understanding that patient-, disease- and treatment-related factors should be considered at all stages of the disease. RRMM is based on definitions of the international myeloma working group (IMWG) and includes biochemical progression, such as paraprotein increase, or symptomatic relapse with CRAB criteria (hypercalcemia, renal impairment, anemia, bone lesions). When choosing RRMM-treatment, the biochemical markers for progression and severity of the disease, dynamic of disease relapse, type and number of prior therapy lines, including toxicity and underlying health status, need to be considered, and shared decision making should be pursued. Objectively characterizing health status via geriatric assessment (GA) at each multiple myeloma (MM) treatment decision point has been shown to be a better estimate than via age and comorbidities alone. The well-established national comprehensive cancer network, IMWG, European myeloma network and other national treatment algorithms consider these issues. Ideally, GA-based clinical trials should be supported in the future to choose wisely and efficaciously from available intervention and treatment options in often-older MM adults in order to further improve morbidity and mortality.
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Gatellier L, Shankar A, Dewi LKM, Hussain QM, Dendup Wangdi T, Sukumaran DB, Sari NK, Tavakkoli Shiraji S, Biglari M, Tahmasebi M, Iwata S, Suzuki T, Myung SK, Chun JY, Han JS, Lau FN, Yusak S, Bayarsaikhan L, Mu KT, Pradhananga KK, Yusuf A, Lin CH, Chiang RCJ, Sangrajran S, Nguyen QT, Huong GN, Soe AN, Sharma DN, Sengar M, Pramesh CS, Matsuda T, Jarrahi AM, Hwang W. The Impact of COVID-19 on Cancer Care in the Post Pandemic World: Five Major Lessons Learnt from Challenges and Countermeasures of Major Asian Cancer Centres. Asian Pac J Cancer Prev 2021; 22:681-690. [PMID: 33773529 PMCID: PMC8286686 DOI: 10.31557/apjcp.2021.22.3.681] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Indexed: 12/23/2022] Open
Abstract
Objective: The COVID-19 pandemic has dramatically affected healthcare services around Asia. The Asian National Cancer Centres Alliance and the Asia-Pacific Organisation for Cancer Prevention collaborated to assess the mid- and long- term impact of COVID-19 to cancer care in Asia. Methods: The two entities organised a combined symposium and post-meeting interactions among representatives of major cancer centres from seventeen Asian countries to outlining major challenges and countermeasures. Results: Participating stakeholders distilled five big questions. 1) “Will there be an explosion of late-stage cancers after the pandemic?” To address and recover from perceived delayed prevention, screening, treatment and care challenges, collaboration of key stakeholders in the region and alignment in cancer care management, policy intervention and cancer registry initiatives would be of essential value. 2) “Operations and Finance” The pandemic has resulted in significant material and financial casualties. Flagged acute challenges (shortages of supplies, imposition of lockdown) as well as longer-standing reduction of financial revenue, manpower, international collaboration, and training should also be addressed. 3) “Will telemedicine and technological innovations revolutionize cancer care?” Deploying and implementing telemedicine such as teleconsultation and virtual tumour boards were considered invaluable. These innovations could become a new regular practice, leading to expansion of tele-collaboration through collaboration of institutions in the region. 4) “Will virtual conferences continue after the pandemic?” Virtual conferences during the pandemic have opened new doors for knowledge sharing, especially for representatives of low- and middle-income countries in the region, while saving time and costs of travel. 5) “How do we prepare for the next pandemic or international emergency?” Roadmaps for action to improve access to appropriate patient care and research were identified and scrutinised. Conclusion: Through addressing these five big questions, focused collaboration among members and with international organisations such as City Cancer Challenge will allow enhanced preparedness for future international emergencies.
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Affiliation(s)
| | - Abhishek Shankar
- Lady Hardinge Medical College & Associated Hospitals, Delhi, India
| | - Luh K Mela Dewi
- Dharmais Hospital - National Cancer Center, Jakarta, Indonesia
| | | | | | | | | | - Sahar Tavakkoli Shiraji
- Hematology, Oncology and Bone Marrow transplantation Research Center, Shariati Hospital, Tehran University of Medical Science,Tehran, Iran
| | - Mohammad Biglari
- Hematology, Oncology and Bone Marrow transplantation Research Center, Shariati Hospital, Tehran University of Medical Science,Tehran, Iran
| | - Mamak Tahmasebi
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Seung-Kwon Myung
- National Cancer Center of Korea, Goyang-si Gyeonggi-do, Republic of Korea
| | - June Young Chun
- National Cancer Center of Korea, Goyang-si Gyeonggi-do, Republic of Korea
| | - Jong Soo Han
- National Cancer Center of Korea, Goyang-si Gyeonggi-do, Republic of Korea
| | - Fen Nee Lau
- National Cancer Institute, Putrajaya, Malaysia
| | | | | | - Khin Thin Mu
- Myanmar Yangon General Hospital, Yangon, Myanmar
| | | | - Aasim Yusuf
- Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan
| | - Ching-Hung Lin
- National Taiwan University Cancer Center Hospital, Taipei City, Taiwan
| | - Ruru Chun-Ju Chiang
- Taiwan Cancer Registry, and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | | | | | | | | | - D N Sharma
- Dr BR Ambedkar Institute Rotary Cancer Hospital & National Cancer Institute, All India Institute of Medical Sciences, Delhi, India
| | - Manju Sengar
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - C S Pramesh
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
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5
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Mohammed T, Ali I, Desai A. COVID-19 in Older Individuals with Cancer: Problem and Potential Solutions. Cancer Invest 2021; 39:214-216. [PMID: 33191802 DOI: 10.1080/07357907.2020.1852567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The ongoing coronavirus disease-2019 (COVID-19) pandemic has radically affected medical practice and healthcare delivery in the United States and beyond. Its impact on vulnerable populations especially older adults battling cancer is striking. Older adults with baseline immunosenescence compounded with multimorbidity and reduced physiological reserves are at even higher risk of succumbing to infection. When it comes to older adults with cancer mortality, it often multifactorial with modifiable risk factors. A specific approach with attention to advance care planning and how cancer care is delivered coupled with a comprehensive geriatric assessment may ultimately be the key to improve overall survival.
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Affiliation(s)
- Turab Mohammed
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Imran Ali
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Aakash Desai
- Department of Hematology, Mayo Clinic, Rochester, MN, USA.,Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA
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6
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Engelhardt M, Shoumariyeh K, Rösner A, Ihorst G, Biavasco F, Meckel K, von Metzler I, Theurich S, Hebart H, Grube M, Kull M, Bassermann F, Schäfer-Eckart K, Hoferer A, Einsele H, Rasche L, Wäsch R. Clinical characteristics and outcome of multiple myeloma patients with concomitant COVID-19 at Comprehensive Cancer Centers in Germany. Haematologica 2020; 105:2872-2878. [PMID: 33256391 PMCID: PMC7716370 DOI: 10.3324/haematol.2020.262758] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Monika Engelhardt
- Freiburg University Medical Center, Department of Internal Medicine I, Faculty of Medicine, University of Freiburg, Freiburg
- German Cancer Consortium (DKTK) Heidelberg, Heidelberg
| | - Khalid Shoumariyeh
- Freiburg University Medical Center, Department of Internal Medicine I, Faculty of Medicine, University of Freiburg, Freiburg
- German Cancer Consortium (DKTK) Heidelberg, Heidelberg
| | - Amelie Rösner
- Freiburg University Medical Center, Department of Internal Medicine I, Faculty of Medicine, University of Freiburg, Freiburg
| | - Gabriele Ihorst
- Clinical Trials Unit Freiburg, Faculty of Medicine, University of Freiburg, Freiburg
| | - Francesca Biavasco
- Freiburg University Medical Center, Department of Internal Medicine I, Faculty of Medicine, University of Freiburg, Freiburg
- German Cancer Consortium (DKTK) Heidelberg, Heidelberg
| | - Katharina Meckel
- Medizinische Klinik und Poliklinik II, Julius- Maximilian-University of Würzburg, Würzburg
| | - Ivana von Metzler
- Universitätsklinik Frankfurt, Department of Hematology and Oncology, University of Franfurt, Frankfurt
| | - Sebastian Theurich
- LMU University Hospital München, Department of Internal Medicine III, Ludwig-Maximilian-University München, München
| | | | - Matthias Grube
- Universitätsklinik Regensburg, Department of Hematology and Oncology, University of Regensburg, Regensburg
| | - Miriam Kull
- Universitätsklinik Ulm, Department of Hematology and Oncology, Univeristy of Ulm, Ulm
| | - Florian Bassermann
- Florian Bassermann Klinikum rechts der Isar, Department of Hematology and Oncology, München
| | | | | | - Hermann Einsele
- Medizinische Klinik und Poliklinik II, Julius- Maximilian-University of Würzburg, Würzburg
| | - Leo Rasche
- Medizinische Klinik und Poliklinik II, Julius- Maximilian-University of Würzburg, Würzburg
| | - Ralph Wäsch
- Freiburg University Medical Center, Department of Internal Medicine I, Faculty of Medicine, University of Freiburg, Freiburg
- German Cancer Consortium (DKTK) Heidelberg, Heidelberg
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7
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Rassy E, Khoury‐Abboud R, Ibrahim N, Assi T, Samra B, Hanna C, Karak FE, Ghosn M. Should we screen patients with hematologic malignancies for
COVID
‐19? Hematol Oncol 2020; 38:648-653. [PMID: 32779823 PMCID: PMC7405152 DOI: 10.1002/hon.2780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/27/2020] [Accepted: 07/13/2020] [Indexed: 01/08/2023]
Abstract
The coronavirus disease (COVID‐19) pandemic has posed several challenges to the hematology community to re‐organize the medical care of patients with hematologic malignancies. Whereas the oncology societies favored a more or less conservative approach which considered the possibility of delaying treatment administration on a case‐by‐case basis, the hematology community guidelines were less stringent and recommended adequate individualized regimens. As countries are de‐escalating the lockdown and the medical community is unable to foresee the end of the current outbreak will and whether the pandemic would eventually come back as a seasonal infection, there is interest in screening of patients with hematology malignancies with COVID‐19 instead of limiting access to curative treatments. The rapidly accumulating knowledge about COVID‐19 allows a better understanding of the diagnostic tools that may be potentially used in screening. Herein, we briefly review the pathophysiology of COVID‐19, the rationale of screening of patients with hematologic malignancies, tools for screening, and available guidelines.
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Affiliation(s)
- Elie Rassy
- Hematology and Oncology Department Saint Joseph University Lebanon
| | | | - Nathalie Ibrahim
- Hematology and Oncology Department Saint Joseph University Lebanon
| | - Tarek Assi
- Hematology and Oncology Department Saint Joseph University Lebanon
| | - Bachar Samra
- Department of Leukemia the University of Texas MD Anderson Cancer Center Houston Texas USA
| | - Colette Hanna
- Hematology and Oncology Department Saint Joseph University Lebanon
| | - Fadi El Karak
- Hematology and Oncology Department Saint Joseph University Lebanon
| | - Marwan Ghosn
- Hematology and Oncology Department Saint Joseph University Lebanon
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8
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Gundavda MK, Gundavda KK. Cancer or COVID-19? A Review of Guidelines for Safe Cancer Care in the Wake of the Pandemic. ACTA ACUST UNITED AC 2020; 2:2691-2701. [PMID: 33251481 PMCID: PMC7679239 DOI: 10.1007/s42399-020-00632-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2020] [Indexed: 01/08/2023]
Abstract
In the wake of the COVID-19 pandemic, due to reasons beyond control, health care workers have struggled to deliver treatment for the patients with cancer. The concern for otherwise healthy patients with curable cancers that require timely intervention or therapy is the risk of contracting COVID-19 may outweigh the benefits of cancer treatment. Lack of international guidelines leaves health care providers with a case-to-case approach for delivering optimal cancer care in the wake of the pandemic. Transition to telemedicine has somewhat bridged the gap for in-office visits, but there is a continuing challenge of delays in cancer screening or significant decline of new diagnoses of cancers due to the pandemic. We aim to propose a balance in risk from treatment delay versus risks from COVID-19 with emphasis on treatment modality (surgery, radiation, and systemic therapy) as well as supportive care for cancer patients, and therefore have reviewed the publications and recommendations from international societies and study groups available as of October 2020.
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Affiliation(s)
- Manit K Gundavda
- Department of Orthopaedic Oncology, P. D. Hinduja National Hospital and Medical Research Centre, Andheri West, Mumbai, Maharashtra 400053 India
| | - Kaival K Gundavda
- Department of Surgical Oncology, Tata Memorial hospital, 93, Ground floor, Main Building, Mumbai, Maharashrta 400012 India
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9
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Kumar P, Aggarwal M, Dhawan R, Dass J, Kumar G, Sharma V, Mirza S, Senapati J, Ganju N, Vaid T, Vijayran M, Panda T, Pragna GS, Krishna SS, Khandelwal A, Verghese R, Tyagi S, Seth T, Mahapatra M. Tele-Medicine Services in Hematological Practice During Covid Pandemic: Its Feasibility and Difficulties. Indian J Hematol Blood Transfus 2020; 37:528-533. [PMID: 33250594 PMCID: PMC7678769 DOI: 10.1007/s12288-020-01385-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 11/12/2020] [Indexed: 12/11/2022] Open
Abstract
In COVID 19 pandemic, delivery and access of health care services have become challenging. Telemedicine services can be considered for management of patients with hematological diseases. This study included all patients who enrolled for telemedicine facility for hematology from May 15 to July 15, 2020. Patient’s demographic and disease related parameters were recorded during the teleconsultation call. Overall satisfaction of attending doctor and patients were also recorded. A total of 1187 teleconsultation appointments were taken, of which 944 (79.6%) were successfully attended. Median age of patients was 38 years (range- 0.5–78 years), with 38% females. 55% of successful calls were from patients suffering a malignant hematological disorder. 24% had an active complaint pertaining to their disease or treatment. Of these, 162 (17%) were asked for a physical consultation. A significant association was found between the requirement of physical consultation and diagnosis (p < 0.001), absence of active complaint (< 0.0001) and education level of responder (p = 0.008). Patients understand that teleconsultation is helpful in preventing COVID-19 infection (71.4%) and avoids outpatient department rush (14.5%) associated with physical appointments; and around 80% patients were satisfied with the teleconsult. With the emergence of COVID 19, many localities under partial lockdown with constant fear of contacting virus amongst patients and health care providers, we can clearly see the advantages as well as feasibility of telemedicine services for our patients. The acute surge in telemedicine could be harnessed in the future to provide comprehensive and integrated care to patients of hematological disorders.
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Affiliation(s)
- Pradeep Kumar
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Mukul Aggarwal
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Rishi Dhawan
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Jasmita Dass
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Ganesh Kumar
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Vishnu Sharma
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Saleem Mirza
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Jayastu Senapati
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Neha Ganju
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Tejasvini Vaid
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Mona Vijayran
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Tribikram Panda
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - G Stitha Pragna
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Sahitya Sri Krishna
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Akash Khandelwal
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Renjith Verghese
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Tyagi
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Tulika Seth
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Manoranjan Mahapatra
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
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10
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Abstract
The COVID-19 pandemic has imposed a critical challenge to the current oncology care and practices including late diagnoses, delayed anti-cancer treatment, and static clinical trials. With the increasing risk of cancer patients acquiring infection during receiving the essential care, the debate ensues on how to balance the risk factors and benefits out of the oncologic emergencies in cancer patients. In this review article, we have focused on the current global re-organization of the integrity and effectiveness of the treatment modalities depending on the patient and cancer-specific urgencies while minimizing exposure to the infection. In this review, we addressed how the worldwide oncology community is united to share therapy schemes and the best possible guidelines to help cancer patients, and to strategize and execute therapy/trial protocols. This review provides collective knowledge on the current re-structuring of the general framework that prioritizes cancer care with the available exploitation of the reduced resources and most importantly the unparalleled levels of companionship as a large health care community towards the need to offer the best possible care to the patients.
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11
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Multiple myeloma and SARS-CoV-2 infection: clinical characteristics and prognostic factors of inpatient mortality. Blood Cancer J 2020; 10:103. [PMID: 33077708 PMCID: PMC7570395 DOI: 10.1038/s41408-020-00372-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/06/2020] [Accepted: 08/06/2020] [Indexed: 12/15/2022] Open
Abstract
There is limited information on the characteristics, prognostic factors, and outcomes of patients with multiple myeloma (MM) hospitalized with COVID-19. This retrospective case series investigated 167 patients reported from 73 hospitals within the Spanish Myeloma Collaborative Group network in March and April, 2020. Outcomes were compared with 167 randomly selected, contemporary, age-/sex-matched noncancer patients with COVID-19 admitted at six participating hospitals. Among MM and noncancer patients, median age was 71 years, and 57% of patients were male; 75 and 77% of patients, respectively, had at least one comorbidity. COVID-19 clinical severity was moderate–severe in 77 and 89% of patients and critical in 8 and 4%, respectively. Supplemental oxygen was required by 47 and 55% of MM and noncancer patients, respectively, and 21%/9% vs 8%/6% required noninvasive/invasive ventilation. Inpatient mortality was 34 and 23% in MM and noncancer patients, respectively. Among MM patients, inpatient mortality was 41% in males, 42% in patients aged >65 years, 49% in patients with active/progressive MM at hospitalization, and 59% in patients with comorbid renal disease at hospitalization, which were independent prognostic factors on adjusted multivariate analysis. This case series demonstrates the increased risk and identifies predictors of inpatient mortality among MM patients hospitalized with COVID-19.
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12
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Glenthøj A, Jakobsen LH, Sengeløv H, Ahmad SA, Qvist K, Rewes A, Poulsen CB, Overgaard UM, Mølle I, Severinsen MT, Strandholdt CN, Maibom J, Kodahl AR, Ryg J, Ravn P, Johansen IS, Helsø SN, Jensen‐Fangel S, Kisielewicz J, Wiese L, Helleberg M, Kirk O, Clausen MR, Frederiksen H. SARS‐CoV‐2 infection among patients with haematological disorders: Severity and one‐month outcome in 66 Danish patients in a nationwide cohort study. Eur J Haematol 2020; 106:72-81. [DOI: 10.1111/ejh.13519] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/08/2020] [Accepted: 09/08/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Andreas Glenthøj
- Department of Haematology Herlev and Gentofte Hospital Hellerup Denmark
| | - Lasse H. Jakobsen
- Department of Haematology Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
| | | | - Syed A. Ahmad
- Department of Haematology Herlev and Gentofte Hospital Hellerup Denmark
| | - Kristian Qvist
- Department of Haematology Holstebro Hospital Holstebro Denmark
| | - Annika Rewes
- Department of Haematology Odense University Hospital Odense Denmark
| | | | | | - Ingolf Mølle
- Department of Haematology Aarhus University Hospital Aarhus Denmark
| | - Marianne T. Severinsen
- Department of Haematology Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
| | | | - Jack Maibom
- Department of Haematology Zeeland University Hospital Roskilde Roskilde Denmark
| | - Annette R. Kodahl
- Department of Oncology Odense University Hospital Odense Denmark
- OPEN Odense University Hospital Odense Denmark
| | - Jesper Ryg
- OPEN Odense University Hospital Odense Denmark
- Department of Geriatric Medicine Odense University Hospital Odense Denmark
- Department of Clinical Research University of Southern Denmark Odense Denmark
- Academy of Geriatric Cancer Research (AgeCare) Odense University Hospital Odense Denmark
| | - Pernille Ravn
- Department of Internal Medicine Section for Infectious Diseases Herlev and Gentofte Hospital Hellerup Denmark
| | - Isik S. Johansen
- OPEN Odense University Hospital Odense Denmark
- Department of Clinical Research University of Southern Denmark Odense Denmark
- Department of Infectious Diseases Odense University Hospital Odense Denmark
| | - Søren N. Helsø
- Department of Haematology Aalborg University Hospital Aalborg Denmark
| | | | - Jacek Kisielewicz
- Department of Haematology Southern Jutland Hospital Aabenraa Denmark
| | - Lothar Wiese
- Department of Infectious Diseases Zeeland University Hospital Roskilde Denmark
| | - Marie Helleberg
- Department of Infectious Diseases Rigshospitalet Glostrup Denmark
| | - Ole Kirk
- Department of Infectious Diseases Rigshospitalet Glostrup Denmark
| | | | - Henrik Frederiksen
- Department of Haematology Odense University Hospital Odense Denmark
- OPEN Odense University Hospital Odense Denmark
- Department of Clinical Research University of Southern Denmark Odense Denmark
- Academy of Geriatric Cancer Research (AgeCare) Odense University Hospital Odense Denmark
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13
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Kurniawan A, Halim DA, Sutandyo N. Multiple Myeloma Management in COVID-19 Era. ASIAN JOURNAL OF ONCOLOGY 2020. [DOI: 10.1055/s-0040-1716813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Abstract
Introduction Coronavirus disease 2019 (COVID-19) has become a world pandemic since early 2020. The complexity of handling multiple myeloma (MM) has increased substantially during this pandemic. The objective of this review is to know the current recommendation to manage MM in the COVID-19 era.
Materials and Methods Electronic databases, including PubMed central and PubMed, were used to conduct a literature search. It was conducted on May 18, 2020, using the keywords “multiple myeloma” AND “COVID-19” AND “Prevalence OR Impact OR treatment OR prophylactic.” The included articles were review articles, recommendations, case reports or series, or population-based studies (cross-sectional, cohort, case-control, or interventional), and full-text if available.
Results A total of 124 articles were identified through the search strategy. The two reviewers screened titles and abstracts of all articles. Most articles were excluded because of ineligible to the criteria. Ultimately, 18 articles were included in the final evaluation. MM patients might have higher risk to become severe COVID-19 if they got infected due to their immunocompromised condition. Due to the pandemic, precise treatment priorities should be made by considering its benefit and the risk of MM progression. For the young, especially healthy patients, the most effective therapy should be offered and tailored to the patient’s goal. Several MM societies have published the recommendation regarding the special stage of MM.
Conclusion Myeloma societies in the world have released recommendations related to the management of myeloma patients. However, there is scarce of evidence to do the recommendation.
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Affiliation(s)
- Andree Kurniawan
- Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Banten, Indonesia
| | | | - Noorwati Sutandyo
- Hematology and Medical Oncology Department, Dharmais Cancer Hospital, Jakarta, Indonesia
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14
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Shoumariyeh K, Biavasco F, Ihorst G, Rieg S, Nieters A, Kern WV, Miething C, Duyster J, Engelhardt M, Bertz H. Covid-19 in patients with hematological and solid cancers at a Comprehensive Cancer Center in Germany. Cancer Med 2020; 9:8412-8422. [PMID: 32931637 PMCID: PMC7666742 DOI: 10.1002/cam4.3460] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 08/16/2020] [Indexed: 12/16/2022] Open
Abstract
Background Patients with cancer are considered a high‐risk group for viral pneumonia, with an increased probability of fatal outcome. Here, we investigated the clinical characteristics and outcome of patients with solid and hematological cancers and concomitant Covid‐19 at a Comprehensive Cancer Center in a Covid‐19 hotspot area in Germany. Methods We performed a retrospective single center cohort study of 39 patients with hematological and solid cancers who were hospitalized at the University Hospital Freiburg for Covid‐19. Using univariate and multivariate Cox regression models we compared time to severe events and overall survival to an age‐matched control cohort of 39 patients with confirmed Covid‐19 without a cancer diagnosis. Results In the cancer cohort 29 patients had a diagnosis of a solid tumor, and 10 had a hematological malignancy. In total, eight patients (21%) in the cancer and 14 patients (36%) from the noncancer cohort died during the observation period. Presence of a malignancy was not significantly associated with survival or time to occurrence of severe events. Major influences on mortality were high IL‐6 levels at Covid‐19 diagnosis (HR = 6.95, P = .0121) and age ≥ 65 years (HR = 6.22, P = .0156). Conclusions Compared to an age‐matched noncancer cohort, we did not observe an association between a cancer diagnosis and a more severe disease course or higher fatality rate in patients with Covid‐19. Patients with a hematological malignancy showed a trend towards a longer duration until clinical improvement and longer hospitalization time compared to patients with a solid cancer. Cancer per se does not seem to be a confounder for dismal outcome in Covid‐19.
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Affiliation(s)
- Khalid Shoumariyeh
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.,German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany
| | - Francesca Biavasco
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Gabriele Ihorst
- Clinical Trials Unit Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Siegbert Rieg
- Division of Infectious Diseases, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Alexandra Nieters
- Institute for Immunodeficiency, Medical Center, University of Freiburg, Freiburg, Germany
| | - Winfried V Kern
- Division of Infectious Diseases, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Cornelius Miething
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.,German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany
| | - Justus Duyster
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.,German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany
| | - Monika Engelhardt
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.,German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany
| | - Hartmut Bertz
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
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15
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Ixazomib-based frontline therapy in patients with newly diagnosed multiple myeloma in real-life practice showed comparable efficacy and safety profile with those reported in clinical trial: a multi-center study. Ann Hematol 2020; 99:2589-2598. [PMID: 32892275 PMCID: PMC7474576 DOI: 10.1007/s00277-020-04234-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 08/24/2020] [Indexed: 02/07/2023]
Abstract
The induction therapy containing ixazomib, an oral proteasome inhibitor, has shown favorable efficacy and safety in clinical trials, but its experience in real-life remains limited. In routine practice, few patients received ixazomib-based induction therapy due to reasons including (1) patients’ preference on oral regimens, (2) concerns on adverse events (AEs) of other intravenous/subcutaneous regimens, (3) requirements for less center visits, and (4) fears of COVID-19 and other infectious disease exposures. With the aim of assessing the real-life effectiveness and safety of ixazomib-based induction therapy, we performed this multi-center, observational study on 85 newly diagnosed multiple myeloma (NDMM) patients from 14 medical centers. Ixazomib-based regimens included ixazomib-lenalidomide-dexamethasone (IRd) in 44.7% of patients, ixazomib-dexamethasone (Id) in 29.4%, and Id plus another agent (doxorubicin, cyclophosphamide, thalidomide, or daratumumab) in 25.9%. Different ixazomib-based therapies were applied due to (1) financial burdens or limitations on local health insurance coverage, (2) concerns on treatment tolerance, and (3) drug accessibility issue. Ten patients received ixazomib maintenance. The median age was 67 years; 43.5% had ISS stage III disease; 48.2% had an Eastern Cooperative Oncology Group performance score ≥ 2; and 17.6% with high-risk cytogenetic abnormalities. Overall response rate for all 85 patients was 95.3%, including 65.9% very good partial response or better and 29.5% complete responses. The median time to response was 30 days. The response rate was similar across different ixazomib-based regimens. Median progression-free survival was not reached. Severe AEs (≥ grade 3) were reported in 29.4% of patients. No grade 3/4 peripheral neuropathy (PN) occurred. Patients received a median of 6 (range 1–20) cycles of ixazomib treatment; 56.6% remained on treatment at data cutoff; 15.3% discontinued treatment due to intolerable AEs. These results support that the ixazomib-based frontline therapy was highly effective with acceptable toxicity in routine practice and the ixazomib oral regimens could be good alternative options for NDMM patients.
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16
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Isidori A, de Leval L, Gergis U, Musto P, Porcu P. Management of Patients With Hematologic Malignancies During the COVID-19 Pandemic: Practical Considerations and Lessons to Be Learned. Front Oncol 2020; 10:1439. [PMID: 32923397 PMCID: PMC7456870 DOI: 10.3389/fonc.2020.01439] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/07/2020] [Indexed: 01/08/2023] Open
Abstract
The COVID-19 pandemic has created unprecedented hurdles to the delivery of care to patients with cancer. Patients with hematologic malignancies appear to have a greater risk of SARS-CoV-2 infection and severe disease due to myelosuppression and lymphopenia. The first challenge, therefore, is how to continue to deliver effective, curative therapy to vulnerable patients and at the same time avoid exposing them, and their health care teams (HCT), to SARS-CoV-2. An additional challenge is the timely completion of the diagnostic and staging studies required to formulate appropriate treatment plans. Deferred procedures and avoidance of multiple trips to the surgical, diagnostic, and laboratory suites require same day consolidation of all procedures. With laboratory medicine absorbed by the need to deploy large scale COVID-testing, the availability of routine molecular tests is affected. Finally, we are increasingly faced with the challenge of making complex treatment decisions in SARS-CoV-2 positive patients with aggressive but potentially curable blood cancers. When to treat, how to treat, when to wait, how long to wait, how to predict and manage toxicities, and how to avoid compromising cure rates remains unknown. We present an outline of the scientific, medical, and operational challenges posed by the COVID-19 pandemic at selected American and European institutions and offer our current view of the key elements of a response. While the peak of the pandemic may be past us, in the absence of a vaccine risks remain, and our alertness and response to future challenges need to be refined and consolidated.
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Affiliation(s)
- Alessandro Isidori
- Hematology and Stem Cell Transplant Center, AORMN Hospital, Pesaro, Italy
| | - Laurence de Leval
- Institute of Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Usama Gergis
- Division of Hematologic Malignancies and Hematopoietic Stem Cell Transplantation, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, United States
| | - Pellegrino Musto
- Unit of Hematology and Stem Cell Transplantation, Department of Emergency and Organ Transplantation, “Aldo Moro” University School of Medicine, AOU Consorziale Policlinico, Bari, Italy
| | - Pierluigi Porcu
- Division of Hematologic Malignancies and Hematopoietic Stem Cell Transplantation, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, United States
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17
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Dersch R, Wehrum T, Fähndrich S, Engelhardt M, Rauer S, Berger B. COVID-19 pneumonia in a multiple sclerosis patient with severe lymphopenia due to recent cladribine treatment. Mult Scler 2020; 26:1264-1266. [PMID: 32762488 DOI: 10.1177/1352458520943783] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Most cases of COVID-19 are considered mild, but patients with immunosuppressant treatment might be prone to severe courses of disease. Expert panels advise to delay treatment with cell-depleting MS therapies during the COVID-19 pandemic. METHODS We report a case of a patient with relapsing-remitting multiple sclerosis who developed COVID-19 pneumonia 2 weeks after the first week of cladribine therapy. RESULTS Despite a severe lymphopenia (absolute lymphocyte count 240/µL), the patient had a moderate course of COVID-19. CONCLUSION Apart from maximal supportive treatment, this could be due to cladribine reducing inflammatory response, which probably contributes considerably to severe courses of COVID-19 pneumonia.
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Affiliation(s)
- Rick Dersch
- Clinic of Neurology and Neurophysiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Thomas Wehrum
- Clinic of Neurology and Neurophysiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sebastian Fähndrich
- Medical Department-Pneumology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Monika Engelhardt
- Medical Department-Hematology, Oncology & Stem Cell Transplantation Clinical Cancer Research Group, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sebastian Rauer
- Clinic of Neurology and Neurophysiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Benjamin Berger
- Clinic of Neurology and Neurophysiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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18
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Terpos E, Engelhardt M, Cook G, Gay F, Mateos MV, Ntanasis-Stathopoulos I, van de Donk NWCJ, Avet-Loiseau H, Hajek R, Vangsted AJ, Ludwig H, Zweegman S, Moreau P, Einsele H, Boccadoro M, San Miguel J, Dimopoulos MA, Sonneveld P. Management of patients with multiple myeloma in the era of COVID-19 pandemic: a consensus paper from the European Myeloma Network (EMN). Leukemia 2020; 34:2000-2011. [PMID: 32444866 PMCID: PMC7244257 DOI: 10.1038/s41375-020-0876-z] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/06/2020] [Accepted: 05/13/2020] [Indexed: 02/07/2023]
Abstract
Patients with multiple myeloma (MM) seem to be at increased risk for more severe COVID-19 infection and associated complications due to their immunocompromised state, the older age and comorbidities. The European Myeloma Network has provided an expert consensus statement in order to guide therapeutic decisions in the era of the COVID-19 pandemic. Patient education for personal hygiene and social distancing measures, along with treatment individualization, telemedicine and continuous surveillance for early diagnosis of COVID-19 are essential. In countries or local communities where COVID-19 infection is widely spread, MM patients should have a PCR test of nasopharyngeal swab for SARS-CoV-2 before hospital admission, starting a new treatment line, cell apheresis or ASCT in order to avoid ward or community spread and infections. Oral agent-based regimens should be considered, especially for the elderly and frail patients with standard risk disease, whereas de-intensified regimens for dexamethasone, bortezomib, carfilzomib and daratumumab should be used based on patient risk and response. Treatment initiation should not be postponed for patients with end organ damage, myeloma emergencies and aggressive relapses. Autologous (and especially allogeneic) transplantation should be delayed and extended induction should be administered, especially in standard risk patients and those with adequate MM response to induction. Watchful waiting should be considered for standard risk relapsed patients with low tumor burden, and slow biochemical relapses. The conduction of clinical trials should continue with appropriate adaptations to the current circumstances. Patients with MM and symptomatic COVID-19 disease should interrupt anti-myeloma treatment until recovery. For patients with positive PCR test for SARS-CoV-2, but with no symptoms for COVID-19, a 14-day quarantine should be considered if myeloma-related events allow the delay of treatment. The need for surveillance for drug interactions due to polypharmacy is highlighted. The participation in international COVID-19 cancer registries is greatly encouraged.
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Affiliation(s)
- Evangelos Terpos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
| | - Monika Engelhardt
- Faculty of Freiburg, Hematology and Oncology Department, Interdisciplinary Cancer Center (ITZ) and Comprehensive Cancer Center Freiburg (CCCF), University of Freiburg, Freiburg, Germany
| | - Gordon Cook
- Leeds Cancer Centre, Leeds Teaching Hospitals National Health Service Trust and University of Leeds, Leeds, UK
| | - Francesca Gay
- Division of Hematology, University of Turin, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Maria-Victoria Mateos
- Cancer Research Unit, University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Institute of Cancer Molecular and Cellular Biology (USAL-CSIC), Centre for Cancer Research (IBMCC), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Ioannis Ntanasis-Stathopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Niels W C J van de Donk
- Department of Hematology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hervé Avet-Loiseau
- Genomics of Myeloma Laboratory, L'Institut Universitaire du Cancer Oncopole, Toulouse, France
| | - Roman Hajek
- Department of Hemato-Oncology, University Hospital Ostrava and Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Annette Juul Vangsted
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Heinz Ludwig
- Wilhelminen Cancer Research Institute, c/o Department of Medical Oncology, Hematology and Palliative Care, Wilhelminenspital Wien, Austria
| | - Sonja Zweegman
- Department of Hematology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Philippe Moreau
- Department of Hematology, University Hospital Hotel-Dieu, Nantes, France
| | - Hermann Einsele
- Department of Internal Medicine II, University Hospital of Würzburg, Würzburg, Germany
| | - Mario Boccadoro
- Division of Hematology, University of Turin, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Jesus San Miguel
- Clínica Universidad de Navarra-Centro de Investigación Médica Aplicada, Instituto de Investigación Sanitaria de Navarra, Centro de Investigación Biomédica en Red de Cáncer, Pamplona, Spain
| | - Meletios A Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Pieter Sonneveld
- Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
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19
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Romito F, Dellino M, Loseto G, Opinto G, Silvestris E, Cormio C, Guarini A, Minoia C. Psychological Distress in Outpatients With Lymphoma During the COVID-19 Pandemic. Front Oncol 2020; 10:1270. [PMID: 32754447 PMCID: PMC7365920 DOI: 10.3389/fonc.2020.01270] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 06/19/2020] [Indexed: 01/18/2023] Open
Abstract
Cancer patients are a population at high risk of contracting COVID-19 and, also of developing severe complications due to the infection, which is especially true when they are undergoing immunosuppressive treatment. Despite this, they had still to go to hospital to receive chemotherapy during lockdown. In this context, we have evaluated the psychological status of onco-hematological outpatients receiving infusion and not deferrable anti-neoplastic treatment for lymphoproliferative neoplasms, with the aim of both measuring the levels of post-traumatic symptoms, depression, and anxiety during the pandemic and also of investigating the perception of risk of potential nosocomial infection. The Impact of Event Scale-Revised (IES-R) and the Hospital Anxiety and Depression Scale (HADS) were administered to all patients. Moreover, patients were investigated about their worries regarding the impact of COVID-19 on their lives as onco-hematologic patients. Since the 2nd to the 29th April 2020 (during the first phase of the lockdown period in Italy), 77 outpatients were prospectively evaluated. They were diagnosed with non-Hodgkin's lymphoma, classical Hodgkin lymphoma, and Chronic lymphocytic leukemia/Small lymphocytic lymphoma. The mean age was 56.6 (range 22-85). We found that 36% of patients had anxiety (HADS-A), 31% depression (HADS-D), and 43% were above the cut-off for the HADS-General Scale; 36% fulfilled the diagnostic criteria for post-traumatic stress disorder (PTSD). Women and younger patients were found to be more vulnerable to anxiety and PTSD. The study firstly analyzes the psychological impact of the COVID-19 pandemic on the frail population of patients affected by lymphoproliferative neoplasms, to underly the importance of screening patients for emotional and distress conditions and then offering them psychological support.
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Affiliation(s)
- Francesca Romito
- Psycho-Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Miriam Dellino
- Gynecology Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Giacomo Loseto
- Hematology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Giuseppina Opinto
- Unit of Hematology and Cell Therapy, Laboratory of Hematological Diagnostics and Cell Characterization, Bari, Italy
| | - Erica Silvestris
- Gynecology Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Claudia Cormio
- Psycho-Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Attilio Guarini
- Hematology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
| | - Carla Minoia
- Hematology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
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20
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Assi T, Samra B, Dercle L, Rassy E, Kattan J, Ghosn M, Houot R, Ammari S. Screening Strategies for COVID-19 in Patients With Hematologic Malignancies. Front Oncol 2020; 10:1267. [PMID: 32719749 PMCID: PMC7348065 DOI: 10.3389/fonc.2020.01267] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 06/18/2020] [Indexed: 12/28/2022] Open
Abstract
COVID-19 has been declared a pandemic by the world health organization. Patients with cancer, and particularly hematologic malignancies may be at higher risk for severe complications due to their malignancy, immune dysregulation, therapy, and associated comorbidities. The oncology community has been proactive in issuing practice guidelines to help optimize management, and limit infection risk and complications from SARS-COV-2. Although hematologic malignancies account for only 10% of all cancers, their management is particularly complex, especially in the time of COVID-19. Screening or early detection of COVID-19 are central for preventative/mitigation strategy, which is the best current strategy in our battle against COVID-19. Herein, we provide an overview of COVID-19 screening strategies and highlight the unique aspects of treating patients with hematologic malignancies.
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Affiliation(s)
- Tarek Assi
- Department of Hematology and Medical Oncology, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Bachar Samra
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Laurent Dercle
- Radiology Department, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY, United States
| | - Elie Rassy
- Department of Hematology and Medical Oncology, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Joseph Kattan
- Department of Hematology and Medical Oncology, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Marwan Ghosn
- Department of Hematology and Medical Oncology, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Roch Houot
- Department of Hematology, CHU de Rennes, Université de Rennes, Rennes, France.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Samy Ammari
- Radiology Department, Gustave Roussy Cancer Campus, Villejuif, France.,BIOMAPS, UMR1281, INSERM.CEA.CNRS, Université Paris-Saclay, Paris, France
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