Hairy cell leukemia and COVID-19 adaptation of treatment guidelines
Michael R. Grever, Leslie A. Andritsos, Versha Banerji, Jacqueline C. Barrientos, Seema A. Bhat, James S. Blachly, Timothy G. Call, Matt Cross, Claire Dearden, Judit Demeter, Sasha Dietrich, Brunangelo Falini, Francesco Forconi, Douglas E. Gladstone, Alessandro Gozzetti, Sunil Iyengar, James B. Johnston, Gunnar Juliusson, Eric H. Kraut, Robert J. Kreitman, Francesco Lauria, Gerard Lozanski, Sameer A. Parikh, Jae H. Park, Aaron Polliack, Farhad Ravandi, Tadeusz Robak, Kerry A. Rogers, Alan Saven, John F. Seymour, Tamar Tadmor, Martin S. Tallman, Constantine S. Tam, Enrico Tiacci, Xavier Troussard, Clive S. Zent, Thorsten Zenz, Pier Luigi Zinzani, Bernhard Wörmann
Abstract
Standard treatment options in classic HCL (cHCL) result in high response rates and near normal life expectancy. However, the disease itself and the recommended standard treatment are associated with profound and prolonged immunosuppression, increasing susceptibility to infections and the risk for a severe course of COVID-19. The Hairy Cell Leukemia Foundation (HCLF) has recently convened experts and discussed different clinical strategies for the management of these patients. The new recommendations adapt the 2017 consensus for the diagnosis and management with cHCL to the current COVID-19 pandemic. They underline the option of active surveillance in patients with low but stable blood counts, consider the use of targeted and non-immunosuppressive agents as first-line treatment for cHCL, and give recommendations on preventive measures against COVID-19.