Stephen Schuster, MD, on Prioritizing Patients with Aggressive Lymphomas During COVID-19 Pandemic

Stephen Schuster, MD, discussed how they are prioritizing patients with more aggressive lymphomas, with an emphasis on tumor volume and serum LDH levels during the COVID-19 pandemic.

Transcription:

We’ve gotten very good at assessing risk for not making it to collection. Basically, the 2 primary variables that we found are the tumor volume, the bulk of tumor that a patient has, also the serum LDH which effects the proliferative capacity or growth rate of the tumor. Patients with high serum LDH and high tumor volume are less likely to stay stable. Again, these are all patients that are refractory to existing therapy so it’s hard to keep them stable, although we try some things for so called ‘bridging’: steroids, novel agents, lenalidomide, ibrutinib for some patients, which occasionally will work. In these high volume, very-high risk for rapid progression, in those cases we’ll move those patients ahead as opposed to the patient that’s in a near complete remission with a normal LDH that’s likely to be stable for a week or 2 longer. There, we really have not had any problems by adjusting the collection schedule-that’s usually where it gets adjusted. Who’s in line to have their apheresis performed and their cells collected? That’s where we might adjust and prioritize one patient over another. And we’ve done it a few times, no problems in terms of people not making it to infusion because of a delay in collection, etc.