Corona virus disease (COVID)-19, the disease caused by SARS-CoV-2, has become a pandemic and sub Saharan Africa including Nigeria have been affected by the disease. The health and socio-economic impact of COVID- 19 is far reaching. For cancer patients and specifically blood cancer patients, the effect is even peculiar due to the intrinsic characteristics.

What do you need to know as a blood cancer patient? We have compiled frequently asked questions and provided the best response based on currently available knowledge and evidence. We will continue to update these information and recommendations as they are developed.

General for all blood cancers

Are blood cancer patients at high risk for COVID-19?

People with cancers, on cancer treatment or cancer survivors may be predisposed to contracting COVID-19 and may suffer severe infection due to possible immune suppression.

Chronic Lymphocytic Leukemia

Will I continue or stop receiving chemotherapy and immunotherapy during this pandemic?

After discussing with you, your consultant may recommend deferring or delaying treatment, if they feel it is your best interest. Please do not stop any treatment for CLL without discussing this with your consultant or a member of their team first.

Myeloma

I’m a newly diagnosed myeloma patient and I have been planned to get transplant after my initial treatment but the process has not began. What should be done?

The whole process of the transplantation (collection and storage) should be delayed until after the corona virus pandemic. (Mayo Clinic Recommendation)

I have been scheduled for transplantation and I have arrived at the site for the process. Should the process continue?

The stem cells should be collected and stored but the transplantation should be delayed until after the corona virus pandemic. (Mayo Clinic Recommendation)

Myeloproliferative neoplasms (MPNs)

As a patient with polycythemia vera should I continue with my regular phlebotomy?

Patients maintained on phlebotomy for polycythemia vera may skip or decrease the frequency for a short period if they are stable, although increased fluid intake is recommended if tolerated to reduce blood viscosity.

Transplantation

Which blood cancer patients can still proceed with allogeneic transplantation during this COVID-19 pandemic?

High risk acute myeloid leukemia (AML) patients in first complete remission (CR1), high risk AML and acute lymphoblastic leukemia (ALL) patients beyond CR1 and secondary AML patients. (Fred Hutchinson Recommendation).

Which blood cancer patients can still proceed with autologous transplantation during this COVID-19 pandemic?

Patients with aggressive lymphomas [such as diffuse large B-cell lymphoma (DLBCL), etc] requiring and eligible for transplantation. (Fred Hutchinson Recommendation).

For more information

https://www.lls.org/public-health/coronavirus

https://hemonc.org/wiki/COVID-19_coronavirus_and_cancer

https://www.hematology.org/covid-19/covid-19-and-myeloproliferative-neoplasms