Australian and New Zealand consensus statement on the management of lymphoma, chronic lymphocytic leukaemia and myeloma during the COVID-19 pandemic

Pietro Di Ciaccio; Georgia McCaughan; Judith Trotman; Phoebe Joy Ho; Chan Y Cheah; Shane Gangatharan; Joel Wight; Matthew Ku; Hang Quach; Robin Gasiorowski; Mark N Polizzotto; Henry Miles Prince; Stephen Mulligan; Constantine S Tam; Gareth Gregory; Greg Hapgood; Andrew Spencer; Michael Dickinson; Maya Latimer; Anna Johnston; Tasman Armytage; Cindy Lee; Tara Cochrane; Leanne Berkhahn; Robert Weinkove; Richard Doocey; Simon J Harrison; Nicholas Webber; Hui-Peng Lee; Scott Chapman; Belinda A Campbell; Simon D J Gibbs; Nada Hamad

doi:10.1111/imj.14859

Australian and New Zealand consensus statement on the management of lymphoma, chronic lymphocytic leukaemia and myeloma during the COVID-19 pandemic

Intern Med J. 2020 Jun;50(6):667-679. doi: 10.1111/imj.14859. Epub 2020 May 15.

Authors

Pietro Di Ciaccio^{1

2}, Georgia McCaughan^{1

2

3}, Judith Trotman^{3

4}, Phoebe Joy Ho^{3

5}, Chan Y Cheah^{6

7

8}, Shane Gangatharan^{8

9}, Joel Wight^{10

11}, Matthew Ku^{11

12}, Hang Quach^{11

12}, Robin Gasiorowski^{3

4}, Mark N Polizzotto^{1

2

13}, Henry Miles Prince^{11

14

15}, Stephen Mulligan^{3

16}, Constantine S Tam^{11

12

14}, Gareth Gregory¹⁷, Greg Hapgood¹⁸, Andrew Spencer^{11

19}, Michael Dickinson^{11

14}, Maya Latimer²⁰, Anna Johnston^{21

22}, Tasman Armytage²³, Cindy Lee²⁴, Tara Cochrane^{25

26}, Leanne Berkhahn^{27

28}, Robert Weinkove^{29

30}, Richard Doocey²⁷, Simon J Harrison^{11

14}, Nicholas Webber³¹, Hui-Peng Lee³², Scott Chapman³³, Belinda A Campbell^{11

34}, Simon D J Gibbs^{35

36}, Nada Hamad^{1

2

3}

Affiliations

¹ Department of Haematology, St Vincent's Hospital, Sydney, New South Wales, Australia.
² University of New South Wales, Sydney, New South Wales, Australia.
³ University of Sydney, Sydney, New South Wales, Australia.
⁴ Department of Haematology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
⁵ Department of Haematology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
⁶ Department of Haematology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
⁷ Department of Haematology, Pathwest Laboratory Medicine, Perth, Western Australia, Australia.
⁸ University of Western Australia, Perth, Western Australia, Australia.
⁹ Department of Haematology, Fiona Stanley Hospital, Perth, Western Australia, Australia.
¹⁰ Townsville University Hospital, Townsville, Queensland, Australia.
¹¹ University of Melbourne, Melbourne, Victoria, Australia.
¹² Department of Haematology, St Vincent's Hospital, Melbourne, Victoria, Australia.
¹³ The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
¹⁴ Department of Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia.
¹⁵ Department of Haematology, Epworth Healthcare, Melbourne, Victoria, Australia.
¹⁶ Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia.
¹⁷ Department of Haematology, Monash Health, Melbourne, Victoria, Australia.
¹⁸ Department of Haematology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
¹⁹ Department of Haematology, The Alfred Hospital, Melbourne, Victoria, Australia.
²⁰ Department of Haematology, Canberra Hospital, Canberra, Australian Capital Territory, Australia.
²¹ Department of Haematology, The Royal Hobart Hospital, Hobart, Tasmania, Australia.
²² University of Tasmania, Hobart, Tasmania, Australia.
²³ Department of Haematology, Gosford Hospital, Gosford, New South Wales, Australia.
²⁴ Department of Haematology, Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
²⁵ Department of Haematology, Gold Coast University Hospital, Southport, Queensland, Australia.
²⁶ Griffith University, Brisbane, Queensland, Australia.
²⁷ Department of Haematology, The Auckland City Hospital, Auckland, New Zealand.
²⁸ University of Auckland, Auckland, New Zealand.
²⁹ Department of Haematology, Wellington Blood and Cancer Centre, Capital and Coast District Health Board, Wellington, New Zealand.
³⁰ Cancer Immunotherapy Programme, Malaghan Institute of Medical Research, Wellington, New Zealand.
³¹ Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
³² Department of Haematology, Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia.
³³ Department of Infectious Diseases, St Vincent's Hospital, Sydney, New South Wales, Australia.
³⁴ Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
³⁵ Department of Haematology, Eastern Health, Melbourne, Victoria, Australia.
³⁶ Monash University, Melbourne, Victoria, Australia.

PMID: 32415723
DOI: 10.1111/imj.14859

Abstract

The COVID-19 pandemic poses a unique challenge to the care of patients with haematological malignancies. Viral pneumonia is known to cause disproportionately severe disease in patients with cancer, and patients with lymphoma, myeloma and chronic lymphocytic leukaemia are likely to be at particular risk of severe disease related to COVID-19. This statement has been developed by consensus among authors from Australia and New Zealand. We aim to provide supportive guidance to clinicians making individual patient decisions during the COVID-19 pandemic, in particular during periods that access to healthcare resources may be limited. General recommendations include those to minimise patient exposure to COVID-19, including the use of telehealth, avoidance of non-essential visits and minimisation of time spent by patients in infusion suites and other clinical areas. This statement also provides recommendations where appropriate in assessing indications for therapy, reducing therapy-associated immunosuppression and reducing healthcare utilisation in patients with specific haematological malignancies during the COVID-19 pandemic. Specific decisions regarding therapy of haematological malignancies will need to be individualised, based on disease risk, risks of immunosuppression, rates of community transmission of COVID-19 and available local healthcare resources.

Keywords: COVID-19; chronic lymphocytic leukaemia; lymphoma; myeloma.

MeSH terms

Australia
Betacoronavirus / immunology
COVID-19
Comorbidity
Consensus*
Coronavirus Infections / epidemiology*
Coronavirus Infections / immunology
Coronavirus Infections / prevention & control*
Coronavirus Infections / virology
Drug Therapy
Guideline Adherence
Humans
Infection Control / methods*
Leukemia, Lymphocytic, Chronic, B-Cell / immunology
Leukemia, Lymphocytic, Chronic, B-Cell / physiopathology*
Leukemia, Lymphocytic, Chronic, B-Cell / therapy
Lymphoma / immunology
Lymphoma / physiopathology*
Lymphoma / therapy
Multiple Myeloma / immunology
Multiple Myeloma / physiopathology*
Multiple Myeloma / therapy
New Zealand
Pandemics / prevention & control*
Pneumonia, Viral / epidemiology*
Pneumonia, Viral / immunology
Pneumonia, Viral / prevention & control*
Pneumonia, Viral / virology
Practice Guidelines as Topic
Risk Assessment
SARS-CoV-2
Salvage Therapy / methods
Stem Cell Transplantation / methods