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Hairy cell leukemia and COVID-19 adaptation of treatment guidelines
Michael Grever1, Leslie Andritsos2, Versha Banerji3,4
1Division of Hematology, Department of Medicine, The Ohio State University, Columbus, OH, USA. Michael.grever@osumc.edu.
Insights
Classic Hairy Cell Leukemia (cHCL) treatment causes immunosuppression, raising infection risks. New HCL Foundation guidelines suggest active surveillance and non-immunosuppressive therapies to mitigate COVID-19 risks in cHCL patients.
Area of Science:
- Hematology
- Oncology
- Infectious Disease
Background:
- Classic Hairy Cell Leukemia (cHCL) standard treatments offer high response rates but cause prolonged immunosuppression.
- This immunosuppression increases infection susceptibility and severe COVID-19 risk in cHCL patients.
- The Hairy Cell Leukemia Foundation (HCLF) convened experts to address cHCL management during the COVID-19 pandemic.
Purpose of the Study:
- To adapt existing cHCL diagnosis and management consensus guidelines for the COVID-19 pandemic.
- To provide updated clinical strategies for managing cHCL patients amidst ongoing viral threats.
- To offer recommendations for preventing COVID-19 in this vulnerable patient population.
Main Methods:
- Expert consensus meeting convened by the Hairy Cell Leukemia Foundation.
- Review and adaptation of the 2017 cHCL consensus guidelines.
- Discussion of clinical strategies considering the COVID-19 pandemic context.
Main Results:
- Recommendations include active surveillance for patients with stable, low blood counts.
- Consideration of targeted and non-immunosuppressive agents as preferred first-line cHCL treatments.
- Guidelines address preventive measures against COVID-19 for cHCL patients.
Conclusions:
- Updated cHCL management strategies are necessary during the COVID-19 pandemic.
- Prioritizing non-immunosuppressive therapies and active surveillance may reduce infection risks.
- Proactive preventive measures are crucial for safeguarding cHCL patients from COVID-19.
Abstract:
Standard treatment options in classic HCL (cHCL) result in high response rates and near normal life expectancy. However, the disease itself and the recommended standard treatment are associated with profound and prolonged immunosuppression, increasing susceptibility to infections and the risk for a severe course of COVID-19. The Hairy Cell Leukemia Foundation (HCLF) has recently convened experts and discussed different clinical strategies for the management of these patients. The new recommendations adapt the 2017 consensus for the diagnosis and management with cHCL to the current COVID-19 pandemic. They underline the option of active surveillance in patients with low but stable blood counts, consider the use of targeted and non-immunosuppressive agents as first-line treatment for cHCL, and give recommendations on preventive measures against COVID-19.
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