Treating Leukemia in the Time of COVID-19

被引:52
|
作者
Paul, Shilpa [1 ]
Rausch, Caitlin R. [1 ]
Jain, Nitin [2 ]
Kadia, Tapan [2 ]
Ravandi, Farhad [2 ]
DiNardo, Courtney D. [2 ]
Welch, Mary Alma [2 ]
Dabaja, Bouthaina S. [3 ]
Daver, Naval [2 ]
Garcia-Manero, Guillermo [2 ]
Wierda, William [2 ]
Pemmaraju, Naveen [2 ]
Bravo, Guillermo Montalban [2 ]
Thompson, Philip [2 ]
Verstovsek, Srdan [2 ]
Konopleva, Marina [2 ]
Kantarjian, Hagop [2 ]
Jabbour, Elias [2 ]
机构
[1] Univ Texas MD Anderson Canc Ctr, Div Pharm, Houston, TX 77030 USA
[2] Univ Texas MD Anderson Canc Ctr, Dept Leukemia, 1515 Holcombe Blvd,Box 428, Houston, TX 77030 USA
[3] Univ Texas MD Anderson Canc Ctr, Dept Radiat Oncol, Houston, TX 77030 USA
关键词
Acute leukemia; Chronic leukemia; Myelodysplastic syndrome; COVID-19; ACUTE LYMPHOBLASTIC-LEUKEMIA; ACUTE PROMYELOCYTIC LEUKEMIA; LOW-INTENSITY CHEMOTHERAPY; TRANS-RETINOIC ACID; MYELODYSPLASTIC SYNDROME; ARSENIC TRIOXIDE; HYPER-CVAD; SCORING SYSTEM; BLINATUMOMAB; COMBINATION;
D O I
10.1159/000508199
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The coronavirus disease 2019 (COVID-19) pandemic poses several challenges to the management of patients with leukemia. The biology of each leukemia and its corresponding treatment with conventional intensive chemotherapy, with or without targeted therapies (venetoclax, FLT3 inhibitors, IDH1/2 inhibitors, Bruton's tyrosine kinase inhibitors), introduce additional layers of complexity during COVID-19 high-risk periods. The knowledge about COVID-19 is accumulating rapidly. An important distinction is the prevalence of "exposure" versus "clinical infectivity," which determine the risk versus benefit of modifying potentially highly curative therapies in leukemia. At present, the rate of clinical infection is 30% in patients with cancer, careful consideration should be given to the risk of COVID-19 in leukemia. Instead of reducing patient access to specialized cancer centers and modifying therapies to ones with unproven curative benefit, there is more rationale for less intensive, yet effective therapies that may require fewer clinic visits or hospitalizations. Here, we offer recommendations on the optimization of leukemia management during high-risk COVID-19 periods.
引用
收藏
页码:132 / 144
页数:13
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