Has the COVID-19 pandemic limited our treatment options for patients with mantle cell lymphoma? To answer this, Dr. Thomas Kipps reviews key treatment challenges and considerations for these patients amid the ongoing pandemic.
Managing MCL Amid the Pandemic: Key Challenges & Treatment Considerationsclose
You’re listening to Project Oncology on ReachMD, sponsored by Lilly. Here’s Dr. Thomas Kipps.
The COVID-19 pandemic has made patients reluctant to come in for infusional treatment. Also, commuting if they live a fair distance from the medical center, has been a challenge because they're less likely to want to fly. And it's complicated driving, particularly if it's longer distance. I think we have taken steps within our infusion room, though, to really safeguard patients. And I think patients do feel protected by patients who are tested for whether they have COVID-19. Before they come into the infusion room patients are socially distanced and everyone is screened. We don't allow visitors or other family members in the infusion room. And I think we've had a very low incidence of any, to my knowledge, any patient becoming infected by coming into the infusion room. So I think that although it may be a challenge, with the appropriate marshaling of personnel, you can make infusion rooms feel safe and be safe for our patients.
Obviously, if we had regimens which were completely oral, requiring no infusions, that would be simpler, and some have opted to use oral medication such as the BTK inhibitors, for treatment at least, and maybe mitigating the times that they have to come into the infusion room for treatment of multi-agent chemotherapy. So this is a consideration but I do think steps can be taken to improve the safety of having patients come in for systemic infusions.
Well, we've adapted our approach. We do telemedicine, but I think also patients who can travel, come to the medical center, we take steps to have patients screened prior to entry, limiting the number of non-patients that might be present and using strict measures to screen patients for COVID-19, who require therapy has really helped a lot in being able to administer these regimens. And so we're trying our best to provide the best care and pay attention to the inherent risks that we have that's posed by COVID-19.
I think the NCCN guidelines have given consideration to the use of these targeted agents in patients with mantle cell lymphoma, even though they were primarily considered to be therapies that had been validated for patients who had already received multi-drug chemoimmunotherapy regimens. And so I think the fact that they do have activity that they can be administered orally, they do not require that patients come in as frequently for monitoring of blood counts has really been helpful and has been incorporated in some of the guidelines during this time of pandemic. And I think that this could be given in consideration particularly for patients who are at high risk for infection, or patients who live a distance from the medical center that makes it more difficult to travel to the medical center and to receive the type of monitoring that would be required with more intensive chemoimmunotherapy regimens.
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