Prevalence of Asymptomatic COVID-19 Infection Among Air Medical Crew

Background: Air medical transport of COVID-19 patients is challenging and presents a high-risk exposure for many air medical crew. Previous investigations have concluded that routine PPE utilized by air medical crew using routing personal protective equipment is safe and effective at preventing symptomatic COVID-19 infections. However, it is unclear to what extent providers may be exposed, contract COVID-19, and remain asymptomatic but potentially contagious. Previous reports suggest up to 6.4% of infected health care personnel are asymptomatic. Method(s): We conducted an IRB approved, primary mixed-methods research study that tested for COVID-19 antibodies in a cohort of participants previously surveyed regarding COVID-19 symptoms. Written consent was obtained by all participants. ELISA testing was performed at the University of New Mexico Center for Global Health Laboratory. Testing included measuring for COVID-19 antibodies in a manner that was independent of vaccination status. Participants also filled out a secure electronic survey to aide in the qualitative data collection and analysis. Result(s): There were 42 participants. Labs samples were obtained between June 2021 and October 2021. Of the 42, 40 were vaccinated (95.2%) and 2 were unvaccinated (4.8%). Of the 40 who were vaccinated, 1 person had the 2-part Moderna vaccine, the rest had the 2-part Pfizer vaccine. 10 of 42 (23.8%) had experienced potential symptoms of COVID-19 at some point in time but had never had a positive test and 32 (76.2%) never experienced any symptoms. Of the 42, 4 had a positive ELISA test for COVID-19 antibody for a positivity rate of 9.52%. Out of the 4 subjects that tested positive, 3 (75%) never experienced any symptoms. Conclusion(s): While the routine use of PPE has been proven to be effective in protecting air medical personnel from symptomatic COVID-19 infection, asymptomatic infection remains a concern. We found that 3 out of 4 that tested positive were asymptomatic. This is significant considering asymptomatic infection poses a risk to air medical crew, patients, coworkers, families, and the general public. Further investigation is required to better ascertain potential gaps in protective equipment or other latent sources of infection that pose risks to air medical crew.Copyright © 2022

The Application of a Brief Mindfulness Intervention in People with Severe Covid-19

Introduction: The practice of mindfulness, formalised in the structuring of well-known protocols such as Mindfulness Based Stress Reduction (MBSR) and Mindfulness Based Cognitive Therapy (MBCT), have proven to be very effective in reducing stress related to chronic conditions (Cherkin et al., 2016;Johns et al., 2015) and of depression (Hilton et al, 2017;Schumer, Lindsay, & David Creswell, 2018). However, these protocols generally require a high level of engagement for participants, which is why, in the present exploratory study, we opted to evaluate the implementation of a shor and less intensive Mindfulness-based protocol, but which showed good results on health-related outcomes, even with a single session (Howarth, Smith, Perkins-Porras, & Ussher, 2019). The overall objective of this exploratory study was to develop and evaluate the implementation of a short-term, Mindfulness-based intervention conducted in telemedicine, compared with usual care alone, on the symptoms associated with Post Traumatic Stress Disorder Stress Disorder (PTSD) of persons who have previously tested positive for COVID-19, admitted to a resuscitation and/or intensive care unit and then in pulmonary rehabilitation following negativization. Method(s): The present pilot randomised controlled trial compared the impact of a Mindfulness-based brief intervention conducted in telemedicine (n=20) for a period of 5-6 sessions of 45 minutes each, for a total commitment of 3 weeks, to a wait-list control (n=20), involving people who have been previously tested positive for COVID-19, admitted to intensive care or reanimation and subsequently in respiratory rehabilitation following negativization. The General Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), Impact of Event Scale (IES), Perceived Stress Scale (PSS), State Shame and Guilt Scale-8, Peritraumatic Perceptions of Fear and life threat, Psychological General Well-being Index (PGWBI), respiratory functions, oxygen saturation, haemogasanalysis were detected at baseline, 3 weeks, and 3 months. Descriptive analyses were conducted with respect to clinical and socio-demographic variables, as well as the primary and secondary outcomes. All statistical analyses were conducted according to an intention-to-treat system. In addition, using linear mixed models, intra- and inter-group comparisons were carried out on the primary and secondary outcome indices. The analyses were considered statistically significant for p<.005. Moreover, semi-structured interviews conducted according to the Interpretative Phenomenological Analysis (IPA) approach detected the participants' emotional experiences, expectations, and beliefs about their experience of illness. Themes that emerged and recurring themes during the course and interviews were analysed from a qualitative point of view, distinguishing the data emerged from the participants' interviews and those from the carers. Result(s): This pilot study found that the Experimental Group pursued improvements in terms of symptoms related to Post Traumatic Stress Disorder (PTSD) and the secondary outcomes outlined above over the course of the three surveys. Furthermore, with regard to the parameters pertaining to respiratory function, spirometry and arterial and venous haematochemical examinations, these were not inferior to those achieved by the Control Group. From the qualitative analysis part, it was possible to detect the presence of descriptive, linguistic, and conceptual comments. Relevant was the theme of contact with death and the emotional experiences associated with it, which emerged in different keys in both patients and caregivers. It is also useful to note the reported progressive change of perspective on how the patient deals with the remaining symptoms of COVID-19 during the proposed sessions. Conclusion(s): This study showed the potential of an affordable and widely accessible Mindfulness-based brief intervention in clinical practice, offering a view of hospital-territory continuity following the acute phase of COVID-19 disease.

Phototherapy to treat a COVID-19 vaccine reaction

A 59-year-old man presented with a widespread morbilliform rash after receiving the second dose of the Pfizer-BioNTech COVID-19 mRNA vaccine. He had no significant medical history and no known allergies. He did not take any regular medication. He developed pruritus without rash 4 h after his first vaccine. This resolved after 10 days without intervention. One day after his second dose, he developed an extensive pruritic morbilliform eruption on his trunk and limbs, affecting 35% of his body surface area. with no mucous membrane involvement. The rash persisted for 4 weeks after his second vaccination and he was referred to dermatology. Eosinophils were raised at 0.54 and liver function tests were normal. Antinuclear antibodies and extractable nuclear antigen were negative. Complement levels were normal. Histology showed mild epidermal acanthosis, spongiosis and subcorneal vesicles. Within the superficial to mid-dermis, there was a mixed chronic inflammatory infiltrate comprising lymphocytes, plasma cells, neutrophils and numerous eosinophils. Direct immunofluorescence was negative. He received a tapering dose of oral prednisolone with mometasone topically. Despite substantial improvement with this regimen, his rash began to worsen 2 days following discontinuation of oral prednisolone. He was still using daily mometasone on cessation of oral steroids. He was trialled on oral doxycycline for 1 month, which led to a marked improvement in the morbilliform rash. Despite improvement in the rash, the patient reported ongoing intense daily pruritus which was having a marked impact on his quality of life. He has commenced on narrowband ultraviolet B (UVB) phototherapy to treat his persistent pruritis, with good effect to date. Morbilliform eruptions have been reported as a cutaneous manifestation of COVID-19 and as a side-effect of mRNA vaccines. Proposed mechanisms for the development of skin rashes post-mRNA vaccines include viral protein expression following vaccination, prior infection with COVID-19 causing cross-reaction with the mRNA vaccine encoded antigen and vaccine components acting as haptens inducing a T helper 2 inflammatory reaction characterized by interleukin (IL)-4 and IL-13 expression. Drug-induced maculopapular eruptions typically resolve within 7-14 days on withdrawal of the culprit medication. The persistent nature in our patient may imply a complex immune response. The use of phototherapy to treat inflammatory dermatoses and pruritic conditions such as nodular prurigo is well described. The antipruritic effect of phototherapy is thought to work via modulation of both the neural pathways involved in itch and local immune cells in the skin. Our case highlights that phototherapy can be used in the treatment of cutaneous side-effects that arise after COVID-19 vaccines. To the best of our knowledge, this case is one of the first to use narrowband UVB phototherapy to treat a cutaneous side-effect of an mRNA vaccine.

How did the Pandemic Affect Health Utilization for Non-COVID-19 People? Mixed Methods Study in Primary and Tertiary Care from Ankara, Turkey?

Aim: We aim to determine the effect of the pandemic on the characteristics of health utilization of non-COVID 19 people. Method(s): Quantitative research was conducted on those who applied to two family health centers (n=200) and Gazi Hospital (n=210) in Ankara. Qualitative research was conducted on health workers or managers from primary care (PC) and tertiary care (TC) (Gazi and Gulhane hospital) and consultants of the Ministry of Health. We also used the health records of Gazi hospital. Result(s): Making an appointment is the most common problem faced by people applying for both PC (19,0%) and TC (32,9%) during the pandemic. The follow-up percentages for PC and TC during the pandemic were 60%-56.3% in DM, 54.2%-54.9% in hypertension, 28.6%-46.2% in COPD, and 16.7%-48.5% in mental health problems, respectively. For all diseases investigated, these percentages were above 80% before the pandemic. During the pandemic period, a sharp decrease between 5% and 85% was observed in outpatients and inpatients due to DM, HT and COPD in Gazi hospital. Participants of the qualitative study stated that delayed admission to the health institution causes more complicated case diagnoses. According to health workers, the groups most affected by the lack of access to healthcare services are demographic group elderly patients and medical group cancer patients. It was emphasized that PC plays an important role in the continuity of health services. Conclusion(s): In the short term, it may be suggested to develop informative materials about conditions that require urgent treatment and follow-up processes of non-communicable diseases (NCDs) during the pandemic. Interruptions in NCDs follow-up and treatment may create the potential for increased morbidity and mortality. Countries should make their plans considering the long-term effects of pandemic on the health system. The pandemic has revealed the importance of PC for accessible and sustainable health care. ©Copyright 2023 by Gazi University Medical Faculty.

DYSPNEIC AFTER EVERY COVID-19 SHOT: SUSPECTED BNT162B2 MRNA VACCINE-RELATED, DRUG-INDUCED PULMONARY EOSINOPHILIA

SESSION TITLE: Issues After COVID-19 Vaccination Case Posters SESSION TYPE: Case Report Posters PRESENTED ON: 10/19/2022 12:45 pm - 01:45 pm INTRODUCTION: Eosinophilia is the most commonly reported adverse event following administration of the Pfizer/BioNTech vaccine, accounting for 237 of 372 events (63.7%). Eosinophilic pneumonia has been described noted in 3 of all reported cases. CASE PRESENTATION: We present the case of a 73 year-old male presented to his PCP with a 3 week history of nonproductive cough and wheezing. He completed a 2-shot series of BNT162b2 mRNA (Pfizer/BioNTech) COVID vaccine 1 week prior to symptom onset. He had no history of respiratory symptoms, smoking, sick contacts, recent travel, chemical or biological exposures. On presentation, he was afebrile, tachycardic and required 3LPM supplemental oxygen to maintain peripheral oxygen saturation (SpO2) above 94%. Laboratory findings noted leukocytosis (13,200/mL) and eosinophilia at 5% (Absolute Eosinophil Count (AEC): 580 cells/L). Respiratory viral panel, procalcitonin, ESR and D-dimer were negative. Chest CT scan was unremarkable. He was treated with azithromycin, prednisone and inhaled bronchodilators with improvement in hypoxia. 2 weeks later, he reported intermittent dyspnea during a pulmonary clinic visit. Pulmonary function testing was normal (FEV1/FVC: 76%;FVC: 3.67L (90% predicted);FEV1: 2.80L (88% predicted). IgE level was normal and eosinophilia had resolved. 6 months after initial symptom onset, the patient received his third BNT162b2 mRNA vaccine dose. 2 weeks after vaccination, he presented to the ED with severe dyspnea, wheezing and cough with yellow sputum. He also noted a new itchy, erythematous bilateral forearm rash and painless oral ulcers. On exam, he was afebrile, tachypneic with SpO2 of 93% on 4LPM supplemental oxygen and audibly wheezing with a prolonged expiratory phase. Laboratory studies noted elevated creatinine and leukocytosis (23,100/mL) with marked eosinophilia (29.5 %, AEC: 6814 cells/L). Chest CT scan revealed a 2 cm rounded ground-glass opacity in the right upper lobe. (Figure 1.) Further workup revealed a weakly positive antihistone antibody (1:4 titer). IgE, ANA, ANCA, SS-A/B, anti-CCP, and complement levels were normal. Intravenous methylprednisolone treatment was initiated with rapid improvement in dyspnea, eosinophilia and renal function. A transbronchial biopsy (Figure 2.) of the RUL lung lesion revealed organizing pneumonia with mixed inflammatory infiltrate. Bronchoalveolar lavage analysis revealed elevated WBC (432 cells/L) with neutrophilic predominance (85%). Patient was discharged home on a prednisone taper with resolution of symptoms. DISCUSSION: Subsequent allergy work up did not indicate any apparent etiology of hypereosinophilia. Testing for strongyloides, coccidiosis and aspergillosis were also negative. A final diagnosis of BNT162b2 mRNA vaccine related pulmonary eosinophilia was made. CONCLUSIONS: Additional study is warranted into eosinophilic disease associated with the BNT162b2 mRNA vaccine. Reference #1: 1. United States Department of Health and Human Services (DHHS), Public Health Service (PHS), Centers for Disease Control (CDC) / Food and Drug Administration (FDA), Vaccine Adverse Event Reporting System (VAERS) 1990 - 03/11/2022, CDC WONDER On-line Database. Accessed at http://wonder.cdc.gov/vaers.html on Mar 11, 2022 1:18:37 PM DISCLOSURES: No relevant relationships by Matthew Haltom No relevant relationships by Nikky Keer No relevant relationships by Thekrayat Khader No relevant relationships by Muthiah Muthiah

Using Individual Clinician Feedback as Key Driver for Multiple Quality Improvement Initiatives at Large Pediatric Urgent Care Network

Purpose/Objectives: Quality improvement (QI) project implementation can be complex and effective interventions can be elusive, especially at large organizations with varied clinician practice. Our institution's large group of physicians and nurse practitioners work within a seven-site pediatric urgent care network in central Ohio. With several simultaneous QI projects we found trends showing varied compliance amongst clinicians that were present across initiatives. Prior studies have shown mixed results for individual clinician feedback as a primary intervention for quality improvement;we hypothesized that it would serve as a key driver in achieving and maintaining our project goals. Design/Methods: In September of 2020 we began emailing monthly individual physician feedback for four QI projects: acute otitis media (AOM) treatment duration, skin and soft tissue infection (SSTI) treatment duration, RSV viral testing rate and viral panel testing rate. The email contained objectives for each project, gave individual performance in relation to goal, and showed ranking compared to peers. Clinician feedback was not punitive, and clinicians' rank was not shared with the larger group. The audits were reviewed for accuracy and populated monthly by QI analyst and physician QI lead. Additionally, group compliance shown as a percentage was presented bimonthly at clinician conferences. Using statistical process control charts, we were able to track progress for all projects concurrently. Results: When scorecards began, AOM and SSTI projects had already improved from baseline while RSV and viral panel testing projects were new. After scorecard initiation, the AOM project had a second baseline shift from 67% to 85% while the SSTI project was sustained at 85% and edged towards 90% (Figure 1). For our respiratory projects, the COVID 19 pandemic had diverging effects. The RSV season abruptly ended and testing dropped precipitously at our institution. As a steady increase in the prevalence of RSV returns, with the scorecard, we have not yet seen an increase in testing and are at less than 1 test per 1000 respiratory visits compared to the pre-pandemic 16 per 1000 respiratory visits (Figure 2). Conversely, for the more comprehensive viral panel testing, we saw a significant increase above the baseline with the pandemic, from 10 per 1000 respiratory visits up to 23 per 1000 respiratory visits. After initiation of the scorecard, we achieved the pre-pandemic goal of 5 per 1000 respiratory visits (Figure 2). Conclusion/Discussion: Our scorecard approach was able to show that getting consistent, reliable, and relevant clinician direct feedback can meaningfully improve clinical practice across varied QI initiatives at different stages of development and with different objectives.

Gaps in Documented Assessments at the Time of Intensive Care Unit Admission

RATIONALE During this unprecedented COVID-19 pandemic intensive care units (ICU) need efficient ways to deliver patient care. As hospital workload increases, so does the risk for medical error and delays in care. A systematic initial approach and timely documentation is important to provide an efficient and thorough assessment and to facilitate communication within the interprofessional team. We aimed to evaluate documentation of key assessment elements at ICU admission. METHODS The Checklist for Early Recognition and Treatment of Acute Illness and Injury (CERTAIN) is a validated tool that reduces errors in the initial assessment and ongoing care of critically ill patients. With Mayo IRB approval, electronic medical records (EMR) of a convenience sample of ICU patients admitted to medical, surgical and mixed ICUs at our institution during October 2021 were reviewed to assess documentation of the CERTAIN primary survey, including assessment of airway, breathing, cardiac, disability, and exposure (ABCDE);vital signs;intravenous access;point of care labs and ultrasound (POCUS);differential diagnosis;and plan by systems including code status and goals of care. Patients admitted for post-operative monitoring and those who declined the use of their medical records for research were excluded. RESULTS Forty patient EMRs were reviewed. Median age was 65 years, 47.5% were female, and respiratory failure was the most common reason for ICU admission. Documented frequency of airway assessment was 32.5%, breathing 92.5%, cardiac 70%, disability 42.5%, and exposure 85%. Thorough vital sign review including temperature was documented in 47.5% of ICU admissions. A comment or plan for intravenous or intraosseous access was documented in 75% of patients. Completion or review of same day point of care labs was documented in 55%. Cardiac POCUS was documented in 9 of 40 ICU admissions. No patients had documented lung or abdominal POCUS. 80% had a differential diagnosis documented as part of their initial assessment. All patients had a complete plan by systems. 85% of patients had a documented code status, although it was unclear if it had been actively re-addressed on ICU admission. CONCLUSION EMR documentation of key findings at the time of ICU admission leaves significant opportunities for improvement, with particularly large gaps in primary survey and POCUS assessment. The results of this study, combined with ongoing direct observation of ICU admissions using the CERTAIN checklist, will inform future recommendations to improve the performance and documentation of key assessment elements during the “golden first hour” of ICU admission.

The potential application of probiotics for the prevention and treatment of COVID-19

Background: Given the severe infection, poor prognosis, and the low number of available effective drugs, potential prevention and treatment strategies for COVID-19 need to be urgently developed. Main body: Herein, we present and discuss the possible protective and therapeutic mechanisms of human microbiota and probiotics based on the previous and recent findings. Microbiota and probiotics consist of mixed cultures of living microorganisms that can positively affect human health through their antiviral, antibacterial, anti-inflammatory, and immunomodulatory effect. In the current study, we address the promising advantages of microbiota and probiotics in decreasing the risk of COVID-19. Conclusions: Thus, we recommend further studies be conducted for assessing and evaluating the capability of these microbes in the battle against COVID-19.

Physical and social distancing measures and child health behaviours during COVID-19: A cohort study

BACKGROUND: Various studies have examined the general impact of the COVID-19 outbreak on children's health behaviours. The impact of public health measures practised by children during COVID-19 is relatively unknown. OBJECTIVES: The primary objective was to determine the association between physical and social distancing measures and children's outdoor time, sleep duration, and screen time during COVID-19. DESIGN/METHODS: A longitudinal study using repeated measures of exposures and outcomes was conducted in healthy children (0 to 10 years) between April 14 and July 15, 2020. Parents were asked to complete questionnaires about isolation, physical distancing practices, and children's health behaviours. The primary exposure was the average number of days that children practised physical and social distancing measures per week. The three outcomes were children's outdoor time, total screen time, and sleep duration during COVID-19. Linear mixed effects models were fitted using repeated measures of primary exposure and outcomes. RESULTS: This study included 554 observations from 265 children. Physical and social distancing measures were associated with shorter outdoor time (-17.2;95% CI-22.07,-12.40;p < 0.001) and longer total screen time (11.3;95% CI 3.88, 18.79;p = 0.003) during COVID-19. The association with outdoor time was stronger in younger children (< 5 years), and the associations with total screen time were stronger in females and in older children (= 5 years). CONCLUSION: Physical and social distancing measures during COVID-19 have resulted in negative impacts on the health behaviours of Canadian children living in a large metropolitan area.

Improved Quality of Life (QOL) with Lisocabtagene Maraleucel (liso-cel), a CD19-Directed Chimeric Antigen Receptor (CAR) T Cell Therapy, Compared with Standard of Care (SOC) As Second-Line (2L) Treatment in Patients (Pts) with Relapsed or Refractory (R/R) Large B-Cell Lymphoma (LBCL): Results from the Phase 3 Transform Study

Background: Pts with previously treated R/R aggressive LBCL have compromised health-related QOL (HRQOL). Liso-cel is an autologous, CD19-directed, defined composition, 4-1BB CAR T cell product administered at equal target doses of CD8 + and CD4 + CAR + T cells. In a prespecified interim analysis of TRANSFORM (NCT03575351), a randomized, open-label, pivotal trial, liso-cel demonstrated statistically significant and clinically meaningful improvement in the primary endpoint of event-free survival and key secondary endpoints (complete response rate and progression-free survival) in adults with R/R LBCL after failure of first-line (1L) immunochemotherapy compared with SOC, with no new safety signals. Here we present results of the pt-reported outcomes (PRO) analysis from TRANSFORM. Methods: Adults (age ≤ 75 yrs) with R/R LBCL (≤ 12 mo after 1L therapy), who were eligible for autologous stem cell transplantation (ASCT), were randomized to receive either SOC (3 cycles of salvage chemotherapy [CT] and BEAM + ASCT for responding pts) or liso-cel after lymphodepletion. Crossover to receive liso-cel was allowed in the SOC arm for pts who failed treatment. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - 30 items (EORTC QLQ-C30) and the Functional Assessment of Cancer Therapy - Lymphoma Subscale (FACT-LymS) were administered at randomization (baseline) and on Days 29 (infusion of liso-cel or 2 cycles of salvage CT), 64 (1 mo post liso-cel or completion of CT), 126 (3 mos post liso-cel or 2 mos post ASCT), and Mo 6 and other prespecified timepoints up to Mo 36 or end of study. No PRO data were collected after crossover. The analysis was based on the PRO-evaluable population (pts with a baseline and ≥ 1 post-baseline assessment). Predefined thresholds determined clinically meaningful changes. Global health/QOL (GH/QOL), physical functioning, cognitive functioning, fatigue, pain, and FACT-LymS were the primary domains of interest based on their relevance to the study population and treatment. A linear mixed model for repeated measures (MMRM) analysis was performed to assess the between-treatment difference in overall least squares (LS) mean change from baseline for each primary domain, using data collected up to Day 126 for visits with a sample size per arm ≥ 10. Proportions of pts with meaningful change from baseline were assessed for each primary domain up to Mo 6. All analyses were descriptive only. Results: Of 184 randomized pts, 90 (49%) and 85 (46%), respectively, were included in the PRO-evaluable population for the EORTC QLQ-C30 (SOC vs liso-cel n=43 vs 47) and FACT-LymS (n=40 vs 45, respectively). The PRO assessment completion rate from baseline up to Mo 6 was ≥ 45%, which was lower than expected primarily due to operational challenges during the COVID-19 pandemic but was comparable for both arms. In the MMRM analysis, the liso-cel arm had more favorable overall LS mean changes from baseline to Day 126 than the SOC arm in most of the EORTC QLQ-C30 domains and FACT-LymS. In particular, the between-treatment differences for cognitive functioning (−2.09 vs 2.21) and fatigue (3.75 vs −1.95) for SOC versus liso-cel, respectively, exceeded the prespecified minimal important difference threshold (Table);in those domains, the SOC arm deteriorated while the liso-cel arm improved. In individual-level analyses, the proportion of pts with meaningful improvement for fatigue and GH/QOL was higher, while deterioration was lower, in the liso-cel arm versus SOC arm from baseline up to Mo 6 (Figure). At Mo 6, a higher proportion of pts experienced worsened fatigue (71% vs 18%) and a lower proportion experienced improved fatigue (29% vs 47%) in the SOC arm compared with the liso-cel arm;for GH/QOL, a higher proportion of pts worsened (57% vs 18%) and lower proportion improved (14% vs 53%), respectively. For the other primary domains, the proportions of pts with improvement or deterioration favored liso-cel or were similar between arms. Conclusions: Compared with SOC, liso-cel sh wed favorable improvement in most primary PRO domains, particularly EORTC QLQ-C30 cognitive functioning and fatigue and more pts showed PRO improvements and fewer showed deterioration by Mo 6 with liso-cel. The results were achieved despite only responders remaining in the SOC arm after salvage CT. HRQOL was either improved or maintained after liso-cel treatment in pts with R/R LBCL after failure of 1L therapy. [Formula presented] Disclosures: Abramson: Bristol-Myers Squibb Company: Consultancy, Research Funding;Morphosys: Consultancy;C4 Therapeutics: Consultancy;Kite Pharma: Consultancy;Kymera: Consultancy;Incyte Corporation: Consultancy;Bluebird Bio: Consultancy;Astra-Zeneca: Consultancy;Allogene Therapeutics: Consultancy;Novartis: Consultancy;EMD Serono: Consultancy;Genmab: Consultancy;Seagen Inc.: Research Funding;AbbVie: Consultancy;Karyopharm: Consultancy;Genentech: Consultancy;BeiGene: Consultancy. Arnason: Juno/BMS: Honoraria. Glass: BMS: Consultancy;Roche: Consultancy, Research Funding, Speakers Bureau;Riemser: Research Funding;Kite: Consultancy;Novartis: Consultancy;Helios Klinik Berlin-Buch: Current Employment. Crotta: Bristol Myers Squibb: Current Employment, Current equity holder in publicly-traded company. Montheard: Bristol Myers Squibb: Current Employment, Current equity holder in publicly-traded company. Previtali: Bristol Myers Squibb: Current Employment, Current equity holder in publicly-traded company. Liu: Bristol Myers Squibb: Current Employment, Current equity holder in publicly-traded company. Braverman: BMS: Current Employment, Current equity holder in publicly-traded company. Guo: Daiichi Sankyo: Consultancy;UCB: Consultancy;Janssen: Consultancy;Gilead: Consultancy;Bristol Myers Squibb: Consultancy;EMD Serono: Consultancy;Evidera: Current Employment. Shi: Bristol Myers Squibb: Consultancy. Kamdar: ADC Therapeutics: Consultancy;Adaptive Biotechnologies: Consultancy;TG Therapeutics: Research Funding;Genentech: Research Funding;AbbVie: Consultancy;KaryoPharm: Consultancy;Kite: Consultancy;AstraZeneca: Consultancy;SeaGen: Speakers Bureau;Celgene: Other;Genetech: Other;Celgene (BMS): Consultancy.