Abstract 326P
Background
Patients with haematologic malignancies, including diffuse large B cell lymphoma (DLBCL), have the highest COVID-19 severity and mortality. It is thus important to balance minimising nosocomial COVID-19 transmission with treatment of aggressive DLBCL. At the National Cancer Centre Singapore (NCCS), we implemented these changes: 1. Reduce outpatient visits for patients on surveillance through telemedicine consultations 2. Low threshold for prophylactic granulocyte stimulating factors (GCSF) to reduce febrile neutropenia 3. Low threshold for antimicrobial prophylaxis 4. Subcutaneous instead of intravenous rituximab to reduce “chair time” in suitable patients 5. Outpatient chemotherapy where possible (including for rituximab with dose-adjusted etoposide, prednisone, vincristine, doxorubicin and cyclophosphamide; DA R-EPOCH for double/triple hit lymphomas) 6. Central Nervous System International Prognostic Index (CNS-IPI) to determine high risk patients requiring CNS prophylaxis; delay CNS prophylaxis with intravenous methotrexate (MTX) to later cycles We then reviewed the data to see if these outcomes had been achieved.
Methods
Data from DLBCL patients between 1 March to 30 April 2019 and the same period in 2020 were reviewed retrospectively and compared. Statistical analysis was performed using the chi-square test (Stata version 16.0, StataCorp, Texas, USA).
Results
There was no nosocomial COVID-19 infection. Inpatient admissions and outpatient visits showed numerical decrease, with significant reduction in surveillance visits (p<0.001). Patients still received appropriate curative treatment. CNS prophylaxis was given when indicated; MTX was given intrathecally during staging lumbar puncture and intravenously later. Most on treatment received GCSF as primary prophylaxis. All who received R-EPOCH also received antimicrobial prophylaxis. There was no difference in number of patients receiving radiation or palliative care.
Conclusions
In- and outpatient visits were successfully reduced with no compromise to treatment and supportive care, with no nosocomial transmission of COVID-19. With no end from the pandemic in sight, this strategy for the management of DLBCL is useful in the “new normal” and for future pandemics of similar nature.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
434P - Pan-Canadian evidence-based, consensus-driven cancer treatment protocols/information for use at the point of care by medical oncologists? Is there a need?
Presenter: Kiran Virik
Session: e-Poster Display Session
435P - Hypnotics and risk of cancer: A meta-analysis of observational studies
Presenter: Tzu Rong Peng
Session: e-Poster Display Session
436P - Clinicopathological characteristics and outcomes of adolescent and young adult (AYA) melanoma: Results from an Asian perspective
Presenter: Wei Lin Goh
Session: e-Poster Display Session
437P - Long-term efficacy and toxicity outcome of adjuvant external beam radiotherapy for medullary thyroid cancer: A single institution cohort study
Presenter: Ka Man Cheung
Session: e-Poster Display Session
438P - Real-world data of relapse after adjuvant treatment (Tx) in high-risk melanoma
Presenter: Carolina Ortiz Velez
Session: e-Poster Display Session
439P - Immunohistochemical analysis of p53 and Ki-67 in glioblastoma (GBM) and their correlations with patient survival
Presenter: Paulo Luz
Session: e-Poster Display Session
440P - Blinded independent central review of oncology trials: The monitoring of readers' performance
Presenter: Hubert Beaumont
Session: e-Poster Display Session
441P - Influence of radiation therapy of patients with somatotropic pituitary adenomas depending on the age of patients
Presenter: Saodat Issaeva
Session: e-Poster Display Session
442P - Results from the registrational phase I/II ARROW trial of pralsetinib (BLU-667) in patients (pts) with advanced RET mutation-positive medullary thyroid cancer (RET+ MTC)
Presenter: Bhumsuk Keam
Session: e-Poster Display Session