Impact of COVID-19 on the management of CLL in 33 Italian centers between March 3, 2020, and April 15, 2020
| Question . | No. (%) of centers . |
|---|---|
| Testing for COVID-19 | |
| Is asymptomatic health-care personnel tested for COVID-19 infection in the absence of known contact with COVID-19 patients? | |
| No | 23 (70) |
| Yes | 7 (21) |
| Yes, at least twice | 3 (9) |
| Patients with CLL are tested using nasopharyngeal swabs | |
| Only if presenting with flu-like illness and/or close contact with a patient with COVID-19 | 23 (70) |
| As in situation above and before treatment administration | 10 (30) |
| Patients admitted to the outpatient department for testing and/or visit and/or treatment | |
| Are screened for body temperature and flu-like symptoms before entrance | 30 (91) |
| Are not screened before entrance | 3 (9) |
| The spaces in the outpatient department are large enough to allow for social distancing (ie, >1 m) to be respected | |
| Yes | 28 (85) |
| Yes, but the access of patients had to be rescheduled | 2 (6) |
| No | 3 (9) |
| Diagnosis and management of patients | |
| Did you notice in the last 40 d a reduction of newly diagnosed patients with CLL? | |
| Yes | 20 (61) |
| No | 13 (39) |
| Did you encounter problems in the diagnostic evaluation? | |
| Yes | 5 (15) |
| No | 28 (85) |
| PhD students and postdoctoral fellows involved in evaluation of patients with CLL | |
| Were admitted to the laboratories without restrictions | 18 (55) |
| Were admitted with some limitations | 10 (30) |
| Were not admitted at all | 5 (15) |
| How were patients with both COVID-19 and CLL managed? | |
| Followed up on a daily basis at home by telephone if asymptomatic or with mild symptoms | 26 (79) |
| Hospitalized independently of the presence of symptoms | 7 (21) |
| Hospitalized patients were assigned | |
| To a dedicated COVID-19 ward | 30 (91) |
| To dedicated single rooms in the hematology ward | 3 (9) |
| Patients not on active CLL treatment who had a scheduled follow-up visit | |
| Were visited regularly | 0 (0) |
| Were contacted by telephone, advised, and rescheduled | 33 (100) |
| Patients with CLL progression requiring treatment according to the iwCLL criteria | |
| Started the planned treatment without delay | 7 (21) |
| Start of treatment was postponed whenever possible | 26 (79) |
| Patients who were on active CLL treatment | |
| Received the planned treatment without modifications (chemoimmunotherapy or oral agents) | 24 (73) |
| Received the planned treatment, but the anti-CD20 monoclonal antibody was not administered | 1 (3) |
| Postponed the scheduled course of chemoimmunotherapy | 8 (24) |
| Patients who were scheduled for restaging during or posttherapy | |
| Were visited without delay | 23 (70) |
| Were rescheduled >1 mo later | 10 (30) |
| Use of blood or platelet transfusion | |
| Had no restriction | 16 (48.5) |
| Had no restriction with an alert that donors were found to be positive for COVID-19 (not transmitted to the patient) | 2 (6) |
| We were advised to reduce use of blood product as much as possible due to shortage of donors | 15 (45.5) |
| Clinical trials | |
| Enrollment of patients with CLL in clinical trials (30 centers) | |
| Continued without significant modifications | 10 (33) |
| We could not enroll patients because the CRO stopped accrual | 10 (33) |
| We reduced our accrual potential for patient’s or physician’s choice | 5 (17) |
| Problems in the follow-up of enrolled patients | 5 (17) |
| Question . | No. (%) of centers . |
|---|---|
| Testing for COVID-19 | |
| Is asymptomatic health-care personnel tested for COVID-19 infection in the absence of known contact with COVID-19 patients? | |
| No | 23 (70) |
| Yes | 7 (21) |
| Yes, at least twice | 3 (9) |
| Patients with CLL are tested using nasopharyngeal swabs | |
| Only if presenting with flu-like illness and/or close contact with a patient with COVID-19 | 23 (70) |
| As in situation above and before treatment administration | 10 (30) |
| Patients admitted to the outpatient department for testing and/or visit and/or treatment | |
| Are screened for body temperature and flu-like symptoms before entrance | 30 (91) |
| Are not screened before entrance | 3 (9) |
| The spaces in the outpatient department are large enough to allow for social distancing (ie, >1 m) to be respected | |
| Yes | 28 (85) |
| Yes, but the access of patients had to be rescheduled | 2 (6) |
| No | 3 (9) |
| Diagnosis and management of patients | |
| Did you notice in the last 40 d a reduction of newly diagnosed patients with CLL? | |
| Yes | 20 (61) |
| No | 13 (39) |
| Did you encounter problems in the diagnostic evaluation? | |
| Yes | 5 (15) |
| No | 28 (85) |
| PhD students and postdoctoral fellows involved in evaluation of patients with CLL | |
| Were admitted to the laboratories without restrictions | 18 (55) |
| Were admitted with some limitations | 10 (30) |
| Were not admitted at all | 5 (15) |
| How were patients with both COVID-19 and CLL managed? | |
| Followed up on a daily basis at home by telephone if asymptomatic or with mild symptoms | 26 (79) |
| Hospitalized independently of the presence of symptoms | 7 (21) |
| Hospitalized patients were assigned | |
| To a dedicated COVID-19 ward | 30 (91) |
| To dedicated single rooms in the hematology ward | 3 (9) |
| Patients not on active CLL treatment who had a scheduled follow-up visit | |
| Were visited regularly | 0 (0) |
| Were contacted by telephone, advised, and rescheduled | 33 (100) |
| Patients with CLL progression requiring treatment according to the iwCLL criteria | |
| Started the planned treatment without delay | 7 (21) |
| Start of treatment was postponed whenever possible | 26 (79) |
| Patients who were on active CLL treatment | |
| Received the planned treatment without modifications (chemoimmunotherapy or oral agents) | 24 (73) |
| Received the planned treatment, but the anti-CD20 monoclonal antibody was not administered | 1 (3) |
| Postponed the scheduled course of chemoimmunotherapy | 8 (24) |
| Patients who were scheduled for restaging during or posttherapy | |
| Were visited without delay | 23 (70) |
| Were rescheduled >1 mo later | 10 (30) |
| Use of blood or platelet transfusion | |
| Had no restriction | 16 (48.5) |
| Had no restriction with an alert that donors were found to be positive for COVID-19 (not transmitted to the patient) | 2 (6) |
| We were advised to reduce use of blood product as much as possible due to shortage of donors | 15 (45.5) |
| Clinical trials | |
| Enrollment of patients with CLL in clinical trials (30 centers) | |
| Continued without significant modifications | 10 (33) |
| We could not enroll patients because the CRO stopped accrual | 10 (33) |
| We reduced our accrual potential for patient’s or physician’s choice | 5 (17) |
| Problems in the follow-up of enrolled patients | 5 (17) |
CRO, contract research organization; iwCLL, International Workshop on Chronic Lymphocytic Leukemia.