7 september 2020: Bron: . 2020 Aug; 4(4): e433. Published online 2020 Jul 30

Aangezien het risico op COVID-19 - coronavirus verhoogd zou kunnen zijn voor volwassenen met kanker, zou de drempel voor het starten van een behandeling met chemokuren hoog moeten zijn bij patiënten met indolente lymfomen, waaronder Waldenström's macroglobulinemie (WM), adviseren artsen en wetenschappers gespecialiseerd op het gebied van die vorm van kanker.

"Waakzaam wachten (wait-and-see beleid) zou waar mogelijk de voorkeursstrategie moeten zijn", aldus de American Society of Hematology (ASH) FAQ over COVID-19 en indolente lymfomen, die eerder deze maand werd bijgewerkt. 

De strategie is van toepassing op zowel patiënten die nog geen behandeling hebben gehad als bij patiënten die een recidief hebben of progressie van hun ziekte.

Dit zijn de vragen waarin in dit studierapport antwoord op wordt gegeven:

  1. V1: Moeten we de indicaties voor therapie bij Waldenström Macroglobulinemie (WM) veranderen?
  2. V2: Moeten we onze benadering van de initiële therapie veranderen?
  3. V3: Moeten we therapieën wijzigen voor niet-COVID-19-positieve patiënten die al met de behandeling zijn begonnen?
  4. V4: Moeten we van therapie veranderen om bezoeken tot een minimum te beperken? Bijvoorbeeld, overschakelen naar orale of minder frequente regimes?
  5. V5: Moeten we onze benadering van ondersteunende zorg veranderen?
  6. V6. Wat zijn de consensusaanbevelingen voor behandeling voor recidiverende / refractaire ziekte?
  7. V7: Hoe zit het met patiënten die deelnamen aan klinische onderzoeken?
  8. V8: Is het waarschijnlijk dat serologische tests voor COVID-19 worden beïnvloed door klonaal IgM bij patiënten met WM?
  9. V9: Moet ik alle WM-patiënten screenen op COVID-19?
  10. V10: Wat moet ik doen als mijn patiënt symptomen vertoont die wijzen op COVID-19?
  11. V11: Wat kunnen we nog meer doen om te helpen?

Zie dit studierapport voor de antwoorden en aanbevelingen

Abstract

In the light of the COVID-19 pandemic, the International Workshop on Waldenström Macroglobulinemia (IWWM) Treatment Recommendations Panel felt the need to provide a consensus statement for the management of Waldenström Macroglobulinemia (WM) patients during this challenging time. We followed the current recommendations by the American Society of Hematology, which have been modified accordingly to fit the specific realities associated with the management of WM. In this Consensus Statement, the Panel addresses questions related to treatment initiation, preferred therapies, minimizing visit to clinics and infusions centers, supportive care and guidance for WM patients in clinical trials. Finally, we also provide information on timing and appropriateness of testing and management of COVID-19 infected patients, as well as ways to get physicians and patients involved in registry studies that could help others.

Introduction

The SARS-CoV-2-associated coronavirus disease 2019 (COVID-19) pandemic has affected patients with blood cancers across the globe. The American Society of Hematology has provided guidance on the management of various blood cancers and disorders during the time of this unique pandemic, in the form of questions and answers. There are mounting data suggesting an increased risk of COVID-19 infection in adults with cancer, and that patients with cancer have an increased risk of severe complications after contracting COVID-19, but it not clear if this is related to the increased age of cancer patients., Given that Waldenström Macroglobulinaemia (WM) is an indolent lymphoma with distinct features and treatment options, the International Workshop on Waldenström Macroglobulinemia provides the following consensus statement along a similar format. In particular, the immunomodulatory and anti-inflammatory responses of Bruton tyrosine kinase inhibitors (BTKi), and the potential risks of cytokine storm and hyperviscosity caused by BTKi withdrawal in worsening late complications of COVID-19 are highlighted. These international consensus recommendations are made based on current understanding of WM and of COVID-19 infection and must be interpreted and applied in the context of new data, as they become available.

Disclosures

DT received research funding and/or honoraria from Amgen, Janssen, Novartis, Roche and Takeda. RHA received research funding and/or honoraria from Genentech, Agensys, AstraZeneca, Autolus, Bayer, BMS, Celgene, Cell Medica, Forty Seven, Gilead, Infinity, Janssen, Kyowa Hakko Kirin, Kura, Merck, Millennium, Pharmacyclics, Regeneron, Roche, Seattle Genetics and Takeda. ARB received honoraria from Pharmacyclics. CB received research funding from Roche, Janssen, Bayer and MSD. MAD received honoraria from participation in advisory boards from Amgen, Takeda, Celgene, Janssen and BMS. SD received Honoraria and grant funding from Janssen, grant funding from BeiGene, Honoraria from Novartis, Advisory Board for Sanofi. EK received research funding and/or honoraria from Amgen, Genesis Pharma, Janssen, Takeda, Pfizer, Research Funding: Amgen, Jansen. MJK received research funding and/or honoraria from Novartis, Kite/Gilead, Celgene, Roche, BMS, Merck, Amgen, Janssen, Miltenyi Biotech. VL received honoraria from Abbvie, Beigene, Roche, Gilead, Janssen, Amgen and AstraZeneca. MCM received research funds and/or honoraria from Celgene/BMS, Janssen, Servier and Kite/Gilead. RGO received research funding from Aztra-Zeneca. MLP honoraria and/or research funding from Janssen and Pharmacyclics. JT received research funding from Pharmacyclics, Janssen, Roche, Celgene and Beigene. AT received honoraria from AbbVie, Janssen, Sunesis and AstraZeneca. SPT received honoraria and/or research funding from Pharmacyclics and BMS. MV received honoraria from Janssen and Roche.

Footnotes

Citation: Talaulikar D, Advani RH, Branagan AR, Buske C, Dimopoulos MA, D'Sa S, Kersten MJ, Leblond V, Minnema MC, Owen RG, Palomba ML, Tedeschi A, Trotman J, Varettoni M, Vos JM, Treon SP, Kastritis E, Castillo JJ. Consensus Statement on the Management of Waldenström Macroglobulinemia Patients During the COVID-19 Pandemic. HemaSphere, 2020;4:4(e433). http://dx.doi.org/10.1097/HS9.0000000000000433

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Articles from HemaSphere are provided here courtesy of Wolters Kluwer Health

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