Blood cancers

COVID-19 registry set up for haematologic malignancies: Prof. Jeff Szer

The American Society of Haematology (ASH) Research Collaborative has launched an international registry of patients who test positive for COVID-19 and have been or are currently being treated for a hematologic malignancy.

The registry said there was an urgent need to rapidly collect and disseminate surveillance data on the natural history of these patients.

“Early published evidence suggests that cancer patients, and potentially even cancer survivors, may be uniquely susceptible to morbidity and mortality from COVID-19. However, existing data are limited and may not be generalisable to patients with haematologic malignancies.”

The COVID-19 Surveillance Registry will capture high-level de-identified data on all malignant haematology patients regardless of recovery or active treatment status.

The registry protocol said its primary purpose was to publicly report near-real time observational data summaries to assist clinicians on the front line of the COVID-19 pandemic. It was not intended for research purposes.

Professor Jeff Szer, from the Peter MacCallum Cancer Centre in Melbourne, told the limbic he supported the concept of the intentional registry.

“To me it seems like a logical way to go. The Italians have got huge experience and New York is developing huge experience and it is all a bit anecdotal at the moment and a registry might help us understand a few things.”

“There are some questions like are bone marrow transplant patients, early post-transplant and in treatment for the first three months or so actually protected from the severe effects of COVID-19? That seems to be the observation in Italy. The contention is that their immunosuppressed state actually protects them from the cytokine storm that does most of the damage.”

He added that he was also interested in one of the proposed mechanisms for the final stages of lung deterioration – a microangiopathic process with endothelial damage, complement activation and localised coagulopathy.

“It’s a picture that looks not dissimilar to aHUS. The Chinese have already reported very high levels of C5a  … the very molecule that is blocked in patients with aHUS and paroxysmal nocturnal haemoglobinuria with anti-complement treatment.”

“There are a bunch of people walking around on such treatment and the question is whether they are protected as well, at least from the severe form.”

Professor Szer said Australia was unlikely to have sufficient numbers for its own registry.

“We may never see a haematology patient at Royal Melbourne or Peter Mac that is infected. So far we have had none. There was that little outbreak at the Alfred but who knows, with the incident cases dropping, it may be that we don’t see one.”

“What I’ve done is supported this and passed it up to the leadership of my department to see what they want to do with it.”

“We are going to have to run it through an ethical process of approval. It is a low risk registry but it still needs to be approved.”

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