Wellington Blood and Cancer Centre, Capital and Coast District Health Board, Wellington, NZ.
Malaghan Institute of Medical Research, Wellington, NZ.
Med J Aust. 2020 Jun;212(10):481-489. doi: 10.5694/mja2.50607. Epub 2020 May 13.
A pandemic coronavirus, SARS-CoV-2, causes COVID-19, a potentially life-threatening respiratory disease. Patients with cancer may have compromised immunity due to their malignancy and/or treatment, and may be at elevated risk of severe COVID-19. Community transmission of COVID-19 could overwhelm health care services, compromising delivery of cancer care. This interim consensus guidance provides advice for clinicians managing patients with cancer during the pandemic.
During the COVID-19 pandemic: In patients with cancer with fever and/or respiratory symptoms, consider causes in addition to COVID-19, including other infections and therapy-related pneumonitis. For suspected or confirmed COVID-19, discuss temporary cessation of cancer therapy with a relevant specialist. Provide information on COVID-19 for patients and carers. Adopt measures within cancer centres to reduce risk of nosocomial SARS-CoV-2 acquisition; support population-wide social distancing; reduce demand on acute services; ensure adequate staffing; and provide culturally safe care. Measures should be equitable, transparent and proportionate to the COVID-19 threat. Consider the risks and benefits of modifying cancer therapies due to COVID-19. Communicate treatment modifications, and review once health service capacity allows. Consider potential impacts of COVID-19 on the blood supply and availability of stem cell donors. Discuss and document goals of care, and involve palliative care services in contingency planning.
This interim consensus guidance provides a framework for clinicians managing patients with cancer during the COVID-19 pandemic. In view of the rapidly changing situation, clinicians must also monitor national, state, local and institutional policies, which will take precedence.
Australasian Leukaemia and Lymphoma Group; Australasian Lung Cancer Trials Group; Australian and New Zealand Children's Haematology/Oncology Group; Australia and New Zealand Society of Palliative Medicine; Australasian Society for Infectious Diseases; Bone Marrow Transplantation Society of Australia and New Zealand; Cancer Council Australia; Cancer Nurses Society of Australia; Cancer Society of New Zealand; Clinical Oncology Society of Australia; Haematology Society of Australia and New Zealand; National Centre for Infections in Cancer; New Zealand Cancer Control Agency; New Zealand Society for Oncology; and Palliative Care Australia.
一种大流行的冠状病毒 SARS-CoV-2 引发了 COVID-19，这是一种潜在的危及生命的呼吸道疾病。由于恶性肿瘤和/或治疗，癌症患者的免疫可能受到损害，并且可能面临 COVID-19 严重感染的风险增加。COVID-19 的社区传播可能会使医疗保健服务不堪重负，从而影响癌症治疗的提供。本临时共识指南为大流行期间管理癌症患者的临床医生提供了建议。
在 COVID-19 大流行期间：对于有发热和/或呼吸道症状的癌症患者，除 COVID-19 以外，还应考虑其他原因，包括其他感染和与治疗相关的肺炎。对于疑似或确诊的 COVID-19，与相关专家讨论暂时停止癌症治疗。为患者和护理人员提供 COVID-19 信息。在癌症中心采取措施降低获得 SARS-CoV-2 的院内感染风险；支持全人群的社会隔离；减少对急症服务的需求；确保充足的人员配置；并提供文化上安全的护理。这些措施应该公平、透明和与 COVID-19 威胁成比例。考虑由于 COVID-19 而修改癌症治疗的风险和益处。一旦医疗服务能力允许，就修改治疗方案并进行审查。考虑 COVID-19 对血液供应和干细胞供者可用性的潜在影响。讨论并记录护理目标，并在应急计划中纳入姑息治疗服务。
本临时共识指南为大流行期间管理癌症患者的临床医生提供了框架。鉴于情况的迅速变化，临床医生还必须监测国家、州、地方和机构政策，这些政策将优先考虑。
澳大利亚白血病和淋巴瘤组；澳大利亚肺癌试验组；澳大利亚和新西兰儿童血液学/肿瘤学组；澳大利亚和新西兰姑息医学协会；澳大利亚传染病学会；澳大利亚和新西兰骨髓移植协会；澳大利亚癌症理事会；澳大利亚癌症护士协会；新西兰癌症协会；澳大利亚临床肿瘤学会；澳大利亚血液学学会；国家癌症感染中心；新西兰癌症控制机构；新西兰肿瘤学会；以及澳大利亚姑息治疗协会。
