The HemOnc & COVID-19 Sessions: treating hematological malignancies, reducing nosocomial COVID-19 infections, clinical trial participation and resource allocation
Jul 28, 2020
auto_awesome
Experts discuss treating hematologic malignancies during the COVID-19 pandemic, reducing nosocomial COVID-19 infections, clinical trial participation, and resource allocation. They highlight challenges in patient management, resource distribution, and the use of telemedicine. The impact on clinical trials, treatment considerations, and the need for international collaboration are also discussed.
Reducing COVID-19 infections in hospitals through dedicated units, airflow adjustments, and handling asymptomatic patients and providers.
COVID-19 impacts resource allocation, causing delays in lab testing, treatment, and interruptions in clinical trial participation.
Minimizing transfusions and utilizing telemedicine in hematologic malignancy management during the pandemic have potential benefits and require ongoing research and adaptation.
Deep dives
Management of Adult Patients with Acute Leukemias and Myeloid Neoplasms in the COVID-19 Era
The podcast episode discusses the management of adult patients with acute leukemias and myeloid neoplasms during the COVID-19 pandemic. The panel of experts explores various topics, including reducing the risk of COVID-19 infections, the impact on clinical trial participation and resource allocation, and the management of patients with specific hematologic malignancies like ALL, CML, MPNs, MDS, and AML. The discussion highlights the challenges faced in making treatment decisions with limited evidence, the importance of individualizing care based on geographic factors, and the potential use of existing therapies for COVID-19. Overall, the episode emphasizes the need for ongoing adaptation, collaboration, and prioritization in the care of hematologic malignancy patients during the pandemic.
Nosocomial Spread and Resource Allocation
The panel addresses the challenges of nosocomial spread of COVID-19 within the hospital and the importance of handling asymptomatic patients and providers to prevent transmission. They discuss the strategies implemented, such as converting regular units to dedicated COVID floors, adjusting airflow, and ensuring dedicated staff for COVID and non-COVID areas. Furthermore, the panel touches upon resource allocation challenges and how COVID-19 affects timely lab testing, delays in treatments like chemotherapy and surgeries, and interruptions in clinical trial participation, potentially impacting long-term outcomes.
Blood Transfusions and Telemedicine
The episode highlights the impact of the pandemic on blood transfusions and the use of telemedicine in managing hematologic malignancies. The panel discusses strategies adopted to minimize transfusions, such as higher hemoglobin thresholds and reducing platelet prophylaxis. They also emphasize the importance of telemedicine in evaluating patients remotely and reducing unnecessary visits to the cancer center. The potential benefits of these changes in practices, as well as the need for continued research and adaptation, are emphasized.
Clinical Trial Participation and Repurposing of Drugs
Clinical trial participation during the pandemic is explored, with considerations for prioritizing trials based on disease space, operational feasibility, and patient safety. The panel discusses the impact of COVID-19 on trial operations, including disruptions in enrollment and logistical challenges. They also highlight the potential for repurposing existing drugs used in hematologic malignancies for COVID-19 treatment, citing examples of anti-inflammatory drugs and therapies targeting inflammation and thrombosis. The need for individualized approaches and the changing landscape of clinical trials in response to the pandemic are underscored.
Management of Acute Leukemias and Myelodysplastic Syndromes
The management of acute leukemias and myelodysplastic syndromes (MDS) during the pandemic is discussed. The panel highlights the importance of individualized treatment decisions based on curative intent and severity of the disease, including considerations for delaying therapy, minimizing visits, and optimizing treatment approaches. Specific topics covered include risk-based therapy strategies, use of growth factors, blood transfusion practices, and the use of telemedicine for patient evaluation and consultation. The challenges of balancing patient safety and necessary interventions are emphasized.
The ongoing COVID-19 pandemic caused by SARS-CoV-2 is an international public health issue and patients with cancer consistently demonstrate poorer post-infection outcomes. In this podcast, Amer Zeidan, MBBS, MHS, Yale University and Yale Cancer Center, New Haven, CT, chairs an exciting discussion with Jan Philipp Bewersdorf, Yale University and Yale Cancer Center, New Haven, CT, Rory Shallis, MD, Yale University and Yale Cancer Center, New Haven, CT, and John Mascarenhas, MD, Icahn School of Medicine at Mount Sinai, New York, NY. These speakers discuss their recent collaborative publication in Lancet Hematology, evaluating the management of adult patients with acute leukemias and myeloid neoplasms in the COVID-19 era.