Clinical activities of the hematology unit before and during the COVID-19 pandemic
| Services . | Baseline, n . | Week 1 (24 Feb) . | Week 2 (2 Mar) . | Week 3 (9 Mar) . | Week 4 (16 Mar) . | Week 5 (23 Mar) . | Week 6 (30 Mar) . |
|---|---|---|---|---|---|---|---|
| Total services | 743.8 | 672 (−10) | 686 (−8) | 738 (−1) | 712 (−4) | 634 (−15) | 599 (−19) |
| Outpatients visits | 446.2 | 312 (−30) | 317 (−29) | 256 (−43) | 208 (−53) | 181 (−59) | 193 (−57) |
| Day-hospital care accesses | 288.6 | 239 (−17) | 270 (−6) | 276 (−4) | 236 (−18) | 198 (−31) | 201 (−30) |
| Transfusions* | 70.3 | 60 (−15) | 55 (−22) | 63 (−10) | 54 (−23) | 53 (−25) | 49 (−30) |
| Therapies† | 136.6 | 102 (−25) | 174 (+27) | 157 (+15) | 123 (−10) | 107 (−22) | 102 (−25) |
| Bone marrow‡ | 32.6 | 23 (−29) | 22 (−32) | 25 (−23) | 25 (−23) | 15 (−54) | 15 (−54) |
| Other§ | 40.3 | 54 (+34) | 19 (−53) | 31 (−23) | 34 (−16) | 23 (−43) | 35 (−13) |
| New admissions to hematology ward | 5 | 5 (0) | 4 (−20) | 8 (+60) | 6 (+20) | 6 (+20) | 6 (+20) |
| New admissions to transplant ward¶ | 4 | 3 (−25) | 5 (+25) | 2 (−50) | 3 (−25) | 2 (−50) | 4 (0) |
| Services . | Baseline, n . | Week 1 (24 Feb) . | Week 2 (2 Mar) . | Week 3 (9 Mar) . | Week 4 (16 Mar) . | Week 5 (23 Mar) . | Week 6 (30 Mar) . |
|---|---|---|---|---|---|---|---|
| Total services | 743.8 | 672 (−10) | 686 (−8) | 738 (−1) | 712 (−4) | 634 (−15) | 599 (−19) |
| Outpatients visits | 446.2 | 312 (−30) | 317 (−29) | 256 (−43) | 208 (−53) | 181 (−59) | 193 (−57) |
| Day-hospital care accesses | 288.6 | 239 (−17) | 270 (−6) | 276 (−4) | 236 (−18) | 198 (−31) | 201 (−30) |
| Transfusions* | 70.3 | 60 (−15) | 55 (−22) | 63 (−10) | 54 (−23) | 53 (−25) | 49 (−30) |
| Therapies† | 136.6 | 102 (−25) | 174 (+27) | 157 (+15) | 123 (−10) | 107 (−22) | 102 (−25) |
| Bone marrow‡ | 32.6 | 23 (−29) | 22 (−32) | 25 (−23) | 25 (−23) | 15 (−54) | 15 (−54) |
| Other§ | 40.3 | 54 (+34) | 19 (−53) | 31 (−23) | 34 (−16) | 23 (−43) | 35 (−13) |
| New admissions to hematology ward | 5 | 5 (0) | 4 (−20) | 8 (+60) | 6 (+20) | 6 (+20) | 6 (+20) |
| New admissions to transplant ward¶ | 4 | 3 (−25) | 5 (+25) | 2 (−50) | 3 (−25) | 2 (−50) | 4 (0) |
Unless otherwise noted, all data are n (percentage change from baseline). The mean for the 3 weeks preceding the COVID-19 pandemic was used as the baseline value.
Transfusions are intended as the number of patients receiving transfusions.
Therapies performed included the following drugs or schemes: adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD), bendamustine, gemcitabine, and vinorelbine (BEGEV), cyclophosphamide, doxorubicine, etoposide, vincristine, and prednisolone (CHEOP), rituximab, cyclophosphamide, doxorubicine, vincristine, and prednisolone (R-CHOP), rituximab, cyclophosphamide, lyposomial doxorubicine, vincristine, and prednisolone (R-COMP), gemcitabine, oxalyplatinum, and prednisolone (GDP), carfilzomib, lenalidomide, dexamethazone (KRD), rituximab, bendamustine, blinatumomab, bortezomib, brentuximab, daratumumab, decitabine, azacitidine, obinutuzumab, cyclophosphamide, elotuzumab, and arsenic trioxide (TRISENOX), and eculizumab. The following therapies were deferred: 3 chemoimmunotherapy cycles for indolent NHL, 17 biologic drugs (4 bortezomib, 12 carfilzomib, 1 daratumumab) for MM and amyloidosis, and 2 hypomethylating agents (azacitidine) for high-risk myelodysplastic syndrome (MDS). Lenalidomide maintenance was interrupted in 5 MM patients, all in long-term remission.
Reasons for bone marrow deferral were routine follow-up of AL (n = 2) and myeloproliferative neoplasms (n = 4), staging of indolent NHL (n = 5), evaluation of monoclonal gammopathy of undetermined significance (n = 3), and reevaluation of immune thrombocytopenia, aplastic anemia, and low-risk MDS (n = 1 each).
Other procedures included IV hydration, phlebotomy, IV immunoglobulin, albumin infusions, lumbar punctures, and venetoclax ramp-up.
Two allogeneic nonurgent transplants for cutaneous NHL were postponed (1 because of the inability to receive the donor’s stem cells from Australia, and 1 because of the temporary unavailability of ICU support). However, 4 allogeneic transplants for acute myeloid leukemia (3 haploidentical and 1 matched unrelated donor) and 5 autologous transplants for MM were performed during the study period.