RESUMO
ABSTRACT: The novel Coronavirus (CoVid-19) outbreak is now consider a world pandemic, affecting more than 1,300,000 people worldwide. Cancer patients are in risk for severe disease, including a higher risk of intensive care unit (ICU) admission, need for invasive ventilation or death. Management of patients with lymphoid malignancies can be challenging during the outbreak, due to need of multiple hospital visits and admissions, immunosuppression and need for chemotherapy, radiotherapy and stem cell transplantation. In this article, we will focus on the practical management of patients with lymphoid malignancies during the COVID-19 pandemic, focusing on minimizing the risk for patients.
Assuntos
Leucemia Linfoide , Coronavirus , COVID-19 , Linfoma , Doença de Hodgkin , Leucemia Linfocítica Crônica de Células B , Linfoma de Células B , Linfoma de Células T Periférico , Linfoma de Célula do MantoAssuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neuropatias do Plexo Braquial/diagnóstico por imagem , Neurolinfomatose/diagnóstico por imagem , Plexo Lombossacral/diagnóstico por imagem , Recidiva , Imageamento por Ressonância Magnética , Neuropatias do Plexo Braquial/patologia , Neuroimagem/métodos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neurolinfomatose/patologia , Plexo Lombossacral/patologiaRESUMO
Abstract Background Despite all the scientific progress that has been made on understanding the disease, prognosis for patients with relapsed and refractory Hodgkin's lymphoma remains poor and the treatment is palliative in the majority of the cases. Thus, the aim of this study was to present the results on the compassionate use of everolimus in a group of patients who were monitored at nine different centers in Brazil. Methods A 10-mg oral dose of everolimus was given to each patient daily. Response time was evaluated from the beginning of medication use until loss of response, toxicity or medical decision to cease treatment. Results Thirty-three patients were evaluated. The median age at the beginning of medication administration was 29 years. Patients had received a median of five prior therapies. Overall response rate was 45.4%, with 13 patients achieving partial response, two achieved clinical response, 14 remained with stable disease, two had disease progression, and two were not evaluated. Patients received a median of 14 cycles. Progression-free survival was nine months, and overall survival was estimated to be 36 months. Three patients used the medication for more than four years. The most frequently reported adverse events were thrombocytopenia and hypercholesterolemia. Three patients had pulmonary toxicity. Grade III and IV adverse events occurred in 39% of the patients. Conclusion Everolimus was found to provide a response in a group of patients with refractory or relapsed Hodgkin's lymphoma who had adequate tolerability to the drug.