06 Dec Patients with Blood Cancers Especially Vulnerable to COVID-19 Infections
MedicalResearch.com Interview with:
William Wood, MD
Associate Professor of Medicine, Division of Hematology
UNC School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In the earliest days of the COVID-19 pandemic, there were concerns that individuals with cancer, and especially those with hematologic malignancies, could be at higher risk for adverse outcomes following COVID-19 infection than the general population. For this reason the ASH Research Collaborative developed a voluntary data collection registry in which providers or sites caring for patients with hematologic malignancies and COVID-19 infection provided de-identified data via an online data collection platform.
We believe that our findings – that 20% of patients with blood cancers who had COVID-19 infection died, including 33% of those who required hospital or ICU level-care – indicate that patients with blood cancers are a medically vulnerable group when it comes to COVID-19. The risk of dying was highest in patients who were older, had more severe infection, opted to forego more intensive treatment, and/or had poorer prognosis before their COVID-19 infection, as determined by their treating clinicians
MedicalResearch.com: What should readers take away from your report?
Response: The key conclusion is that patients with hematologic malignancies are medically vulnerable with regards to COVID-19 infection, and that the risk within this group is unevenly distributed, with several identified and emerging risk factors.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: We believe that this work highlights the need for enhanced data collection systems involving patients with underlying hematologic diseases. Besides the COVID-19 Registry, the ASH Research Collaborative is developing additional programs to help address this gap, including the ASH Research Collaborative Data Hub, a program that directly integrates site EHR data to inform research and care in hematologic conditions, starting with sickle cell disease and multiple myeloma, and expanding to other diseases in the future. The ASH Research Collaborative Data Hub will also be able to develop and test COVID-19 risk mitigation strategies such as enhanced surveillance testing and vaccine distribution.
In the meantime, though, we encourage continued data collection to the ASH RC COVID-19 registry from hematologists around the world, so that the data resource we are building can be used to address further questions about COVID-19 and blood cancer that are relevant to hematologists. We encourage readers to visit the COVID-19 registry website, which can be found through the ASH Research Collaborative at www.ashrc.org. On the COVID-19 registry website, those interested can view near real-time data summaries of the ASH RC COVID-19 registry, can see other key details of the registry including sample data collection forms, and can contribute data on their patients with underlying hematologic conditions and COVID-19 infection.
MedicalResearch.com: Is there anything else you would like to add? Any disclosures?
Response: Because patients with blood cancers are medically vulnerable, we think it is important for these patients and for the healthcare system to continue to take appropriate precautions to limit the risk of acquiring COVID-19. At the same time, most patients who acquired the infection survived, and several lived who had severe disease and required ICU-level care. Thus, providing maximal care to patients with blood cancers and COVID-19 infection appears appropriate if it is consistent with patient and family preferences. As the data matures, the registry may be able to better inform specific risks from specific treatments and specific underlying diseases, which could have impact upon treatment decision-making.
In terms of disclosures, I am the current chair of the ASH Research Collaborative Data Hub Oversight Group.
William A. Wood, Donna S. Neuberg, J. Colton Thompson, Martin S. Tallman, Mikkael A. Sekeres, Laurie H. Sehn, Kenneth C. Anderson, Aaron D. Goldberg, Nathan A. Pennell, Charlotte M. Niemeyer, Emily Tucker, Kathleen Hewitt, Robert M. Plovnick, Lisa K. Hicks; Outcomes of patients with hematologic malignancies and COVID-19: a report from the ASH Research Collaborative Data Hub. Blood Adv 2020; 4 (23): 5966–5975. doi: https://doi.org/10.1182/bloodadvances.2020003170
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