Managing haematology and oncology patients during the COVID-19 pandemic: interim consensus guidance

被引：92

作者：

Weinkove, Robert ^{[1
,2
]}

McQuilten, Zoe K. ^{[3
,4
]}

Adler, Jonathan ^{[5
]}

Agar, Meera R. ^{[6
]}

Blyth, Emily ^{[7
,8
]}

Cheng, Allen C. ^{[3
]}

Conyers, Rachel ^{[9
,10
]}

Haeusler, Gabrielle M. ^{[11
,12
]}

Hardie, Claire ^{[13
]}

Jackson, Christopher ^{[14
,15
]}

Lane, Steven W. ^{[16
]}

Middlemiss, Tom ^{[17
]}

Mollee, Peter ^{[18
,19
]}

Mulligan, Stephen P. ^{[20
]}

Ritchie, David ^{[21
]}

Ruka, Myra ^{[22
,23
]}

Solomon, Benjamin ^{[24
]}

Szer, Jeffrey ^{[11
,21
]}

Thursky, Karin A. ^{[11
,21
]}

Wood, Erica M. ^{[3
,4
]}

Worth, Leon J. ^{[11
,12
]}

Yong, Michelle K. ^{[11
,12
]}

Slavin, Monica A. ^{[11
,12
]}

Teh, Benjamin W. ^{[11
,12
]}

机构：

[1] Wellington Blood & Canc Ctr, Capital & Coast Dist Hlth Board, Wellington, New Zealand

[2] Malaghan Inst Med Res, Wellington, New Zealand

[3] Monash Univ, Melbourne, Vic, Australia

[4] Monash Hlth, Melbourne, Vic, Australia

[5] Wellington Reg Hosp, Capital & Coast Dist Hlth Board, Wellington, New Zealand

[6] Univ Technol, Improving Palliat Aged & Chron Care Clin Res & Tr, Sydney, NSW, Australia

[7] Westmead Hosp, Sydney, NSW, Australia

[8] Westmead Inst Med Res, Sydney, NSW, Australia

[9] Royal Childrens Hosp, Childrens Canc Ctr, Melbourne, Vic, Australia

[10] Murdoch Childrens Res Inst, Melbourne, Vic, Australia

[11] Peter MacCallum Canc Ctr, Melbourne, Vic, Australia

[12] Royal Childrens Hosp, Melbourne, Vic, Australia

[13] MidCent Dist Hlth Board, Palmerston North, New Zealand

[14] Canc Soc New Zealand, Wellington, New Zealand

[15] Univ Otago, Dunedin, New Zealand

[16] Royal Brisbane & Womens Hosp, Brisbane, Qld, Australia

[17] Le Omanga Hosp, Lower Hutt, New Zealand

[18] Princess Alexandra Hosp, Brisbane, Qld, Australia

[19] Univ Queensland, Brisbane, Qld, Australia

[20] Royal North Shore Hosp, Sydney, NSW, Australia

[21] Royal Melbourne Hosp, Melbourne, Vic, Australia

[22] Waikato Dist Hlth Board, Hamilton, New Zealand

[23] Univ Auckland, Auckland, New Zealand

[24] Univ Melbourne, Melbourne, Vic, Australia

来源：

MEDICAL JOURNAL OF AUSTRALIA | 2020年 / 212卷 / 10期

关键词：

Immunosuppression; Hematologic neoplasms; Virus diseases; COVID-19; CELL TRANSPLANT RECIPIENTS; CLINICAL CHARACTERISTICS; OUTCOMES; INFECTIONS; GUIDELINES; DIAGNOSIS; CHILDREN; VIRUS;

D O I：

10.5694/mja2.50607

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction A pandemic coronavirus, SARS-CoV-2, causes COVID-19, a potentially life-threatening respiratory disease. Patients with cancer may have compromised immunity due to their malignancy and/or treatment, and may be at elevated risk of severe COVID-19. Community transmission of COVID-19 could overwhelm health care services, compromising delivery of cancer care. This interim consensus guidance provides advice for clinicians managing patients with cancer during the pandemic. Main recommendations During the COVID-19 pandemic: In patients with cancer with fever and/or respiratory symptoms, consider causes in addition to COVID-19, including other infections and therapy-related pneumonitis. For suspected or confirmed COVID-19, discuss temporary cessation of cancer therapy with a relevant specialist. Provide information on COVID-19 for patients and carers. Adopt measures within cancer centres to reduce risk of nosocomial SARS-CoV-2 acquisition; support population-wide social distancing; reduce demand on acute services; ensure adequate staffing; and provide culturally safe care. Measures should be equitable, transparent and proportionate to the COVID-19 threat. Consider the risks and benefits of modifying cancer therapies due to COVID-19. Communicate treatment modifications, and review once health service capacity allows. Consider potential impacts of COVID-19 on the blood supply and availability of stem cell donors. Discuss and document goals of care, and involve palliative care services in contingency planning. Changes in management as a result of this statement This interim consensus guidance provides a framework for clinicians managing patients with cancer during the COVID-19 pandemic. In view of the rapidly changing situation, clinicians must also monitor national, state, local and institutional policies, which will take precedence. Endorsed by Australasian Leukaemia and Lymphoma Group; Australasian Lung Cancer Trials Group; Australian and New Zealand Children's Haematology/Oncology Group; Australia and New Zealand Society of Palliative Medicine; Australasian Society for Infectious Diseases; Bone Marrow Transplantation Society of Australia and New Zealand; Cancer Council Australia; Cancer Nurses Society of Australia; Cancer Society of New Zealand; Clinical Oncology Society of Australia; Haematology Society of Australia and New Zealand; National Centre for Infections in Cancer; New Zealand Cancer Control Agency; New Zealand Society for Oncology; and Palliative Care Australia.

引用

页码：481 / 489

页数：9

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