Emergency Guidance for Radiation Therapy During Pandemic

(WASHINGTON, April 15, 2020) — As the COVID-19 outbreak continues, clinicians caring for patients with hematologic malignancies may more frequently consider localized radiotherapy, which is associated with less immunosuppression, to temper or substitute systemic therapies such as chemotherapy. At the same time, facilities may be challenged by limited space, equipment, and staff to dedicate to radiation therapy for patients with hematologic malignancies. The International Lymphoma Radiation Oncology Group (ILROG) offers emergency recommendations to manage increased demand in a challenging environment in a new Blood paper. The recommendations include increasing dose per fraction while reducing the number of daily visits, reducing potential virus exposure for patients and providers. It also includes options for delaying or omitting radiation therapy in indolent lymphomas. Maintaining efficacy and safety with the alternative approach is the prime consideration. Experts also outline the potential risks and benefits of each approach to empower clinicians to assess disease factors as well as individual COVID-19 risk to make informed treatment decisions.

The paper’s lead author, Joachim Yahalom, MD, of Memorial Sloan Kettering Cancer Center, said, “The emergency guidelines provide COVID-19 pandemic-relevant considerations for modifying radiotherapy indications and treatment schedules for patients with hematological malignancies. This is an effort to reduce patient and staff exposure by minimizing daily visits and still maintain equivalent efficacy and safety profile. The alternative schedules may be individually adjusted within the suggested boundaries.”

“This important paper by ILROG provides an excellent example of how the medical community is coming together to create cohesive strategies to adapt treatment in the setting of COVID-19 in order to maintain quality care, while lowering toxicity, minimizing viral exposure risk, and decreasing resource utilization,” said Laurie Sehn, MD, MPH, British Columbia Cancer Centre for Lymphoid Cancer.

Blood (www.bloodjournal.org), the most cited peer-reviewed publication in the field of hematology, is available weekly in print and online. Blood is a journal of the American Society of Hematology (ASH) (www.hematology.org).

Contact:
Leah Enser, American Society of Hematology
lenser@hematology.org; 202-552-4927