Dr. Ip on the Challenges of Treating Patients With Hematologic Malignancies and COVID-19

Andrew Ip, MD, MS, a hematologist/oncologist, John Theurer Cancer Center, Hackensack Meridian Health, discusses the challenges of treating patients with hematologic malignancies and COVID-19.

Treating COVID-19 has been difficult; however, unique challenges have emerged with regard to patients with lymphoma, leukemia, and myeloma, says Ip. Currently, approved agents to treat patients with COVID-19 include antiviral drugs, such as remdesivir (Veklury) alone or in combination with baricitinib (Olumiant). Dexamethasone has also demonstrated activity in managing inflammation related to COVID-19. Convalescent plasma, an immune-based therapy that can provide passive immunity, has also been granted Emergency Use Authorization to treat patients with COVID-19. Finally, tocilizumab (Actemra), a monoclonal antibody that is used to treat patients with hematologic malignancies who develop cytokine storm from cellular therapies, has also demonstrated efficacy in treating patients with COVID-19.

Despite these advances, treating patients with hematologic malignancies who develop COVID-19 is challenging because many are on immunosuppressive medications, such as rituximab (Rituxan), CD20-directed monoclonal antibodies or chemotherapy, says Ip. Additionally, patients with cancer and COVID-19 can have severe and prolonged COVID-19 symptoms, Ip explains. As such, additional research is needed to determine the utility of these therapies among patients with hematologic malignancies, concludes Ip.