Coronavirus disease (COVID-19) and CLL patients: Statement of the CLL Advocates Network

As a member of the Steering Committee of CLL Advocates Network (CLLAN), worked on the draft of this statement for the member organizations. CLLAN is an umbrella charity that helps other nonprofits across the world that help CLL patients in 6 continents.

The statement is available in several languages.

While I helped author it and agree with nearly all its advice, I would argue with the German Society of Haematology and Oncology (DGHO) when they stated: “effective treatment of cancer is more important to patient survival than excessive precautionary measures against the new Coronavirus such as treatment interruption or delay in treatment”. While this is applicable in many acute cancers, it may not apply to chronic lymphocytic leukemia. CLL is a chronic disease, and when stable, routine visits during the present pandemic might be better postponed or done remotely in consultation with the patient’s treatment team.

Here is the link to the CLLAN statement.

Consider instead ASH’s COVID-19 and CLL: Frequently Asked Questions for doctors that I quote below:

• Are you changing your approach to initiating therapy for CLL during the pandemic?

It is our practice to postpone treatment initiation if possible. For patients who require immediate therapy, we still offer the best treatment option considering disease and patient-specific factors. When there is more than one option, preference should be given to treatments that can be provided in the outpatient setting and require fewer clinic visits and lab assessments. We try to avoid or skip treatment with monoclonal antibodies (rituximab, obinutuzumab) especially when given in combination with targeted agents. Initiation of venetoclax requires multiple and extended clinic visits with lab testing and should be avoided if possible unless considered the most appropriate treatment for a particular patient.

• Are you changing anything for patients without COVID-19 who are already on therapy for CLL?

When possible, we try to minimize the number of visits for those who are stable and doing well. When follow-up is necessary, utilizing laboratories closer to home and using telemedicine is recommended.

For more from ASH, the leading professional organization for hematologists, please see our link to their important resource here.

Stay safe and stay strong

Brian