Although the health authorities are beginning to talk about easing COVID-19 confinement restrictions, some subgroups like hematological patients and, above all, anyone undergoing chemotherapy treatment or who have recently had a bone marrow transplant, must continue to be particularly careful not to become infected with COVOD-19 and therefore, must continue taking extreme measures with hygiene and isolation.
“It is vital that these patients try to leave home a little as possible and reduce contact with the rest of their family members in confinement as much as possible”, Dr. Adolfo de la Fuente, head of the Hematology Service at MD Anderson Cancer Center Madrid, and Dr. Monica Estevez, coordinator of the center’s Hematopoietic Transplant Program.
Furthermore, even while at home, it is also important to take care. “Family members should limit contact with the patient, clean common areas of the home often and increase the frequency with which they wash their hands”, say the doctors, who also recommend the use of masks when in contact with these patients.
Likewise, it is prudent for them not to come into contact with items from the supermarket, shop or pharmacy until they have been properly disinfected. “These measures will substantially reduce the chance of infection within the home”. Both doctors stress that these recommendations are especially important if the patient has recently been given a bone marrow transplant, particularly in the case of an allogeneic bone marrow transplant.
In the case the patient is in remission, that is, does not have symptoms or any signs of disease, preventive measures may change from one person to another. “It all depends on the type of disease, the treatments and their side effects, the time the patient has been in remission and whether or not there are any other pathologies present”, Drs. De la Fuente and Estevez explain and they recommend consulting a specialist in case of doubt.
So, although the doctors point out that while it may be expected that children and young adults with hematological diseases might progress better and, therefore, have a better prognosis than older patients’, they always recommend consulting a specialist in onco-hematology and, where possible, follow the guidelines on strict hygiene and isolation.
“Because of the highly contagious nature of the virus, the chances of becoming infected are the same, but the chances of the infection being symptomatic or severe are greater because these patients are in a high-risk group”.
Bone Marrow transplants during the COVID-19 pandemic
In accordance with the current recommendations of the European Society for Blood and Marrow Transplantation (EBMT), the Spanish Hematopoietic Transplantation and Cellular Therapy Group (GETH) and the Spanish Group of Lymphoma and Bone Marrow Transplantation (GELTAMO), less urgent transplants can be postponed.
But what happens in urgent cases? And patients who are recently diagnosed? For urgent cases, it is recommended doctors proceed as planned, although “bearing in mind the difficulties of finding an unrelated donor in the current circumstances, collection and transport of grafts, etc.”, Drs. De la Fuente and Estevez explain.
For recently diagnosed cases, the experts state that “individual, personalized checks for each case are vital and allow doctors to establish the degree of urgency in each case”.
In the case of a hospital admission, and to ensure the safety of patients, MD Anderson Madrid has adopted a series of measures to prevent infection with coronavirus. Enhanced precautions have been implemented in reverse isolation (gowns, masks, gloves, boot swabs, caps) and the number of companions has been reduced to one family member per patient.
Likewise, family members with respiratory symptoms, even mild symptoms, cannot visit, and any patient who is a candidate for a transplant must be quarantined at home for 14 days prior to being admitted to hospital. If the patient has come into contact with a confirmed case of coronavirus, the period of quarantine is extended to 21 days.
By adopting these measures, MD Anderson Madrid aims to ensure the safety of patients in all the stages of their disease, from the moment they are diagnosed to when they are admitted to hospital and their subsequent recovery at home.
In addition, the experts insist on the importance of carrying on with regular checks for hematological patients during the period of confinement.