Table 1

Summary of evidence-based discussion points regarding management of patients with CMML during COVID-19 pandemic.

1	Patients with CMML represent an especially vulnerable population to acquire COVID-19, and needs particular attention to prevent COVID-19 infection [4].
2	COVID-19 could mount brisk leukemoid reaction in patients with CMML. In addition to routine infection screen, test of COVID-19 by RT-PCR could be performed in such cases.
3	Prolonged incubation period of COVID-19 in patients with haematological malignancies coupled with false-negative RT-PCR report of SARS-CoV-2 could cause potential diagnostic delays. Repeat testing may be considered after 1 week to confirm the absence of COVID-19 in such cases [8, 9].
4	Lymphopenia in serial CBC might hint towards the possibility of COVID-19 in patients with CMML-SARS-CoV-2 [10].
5	During COVID-19 pandemic, ‘wait and watch’ could be considered for CMML patients with asymptomatic disease. Hydroxyurea could be considered for patients with proliferative CMML in whom treatment is indicated [18].
6	In addition to standard infection screen, testing for COVID-19 may be considered in patients with FN, or diarrhea [10-12, 19].
7	Whenever possible, use of G-CSF should be avoided in COVID-19 positive FN cases due to the risk of worsening pulmonary inflammation, and inducing ARDS [16].
8	Patients with CMML with COVID-19 could have extreme cytokine elevation. Use of anti-cytokine monoclonal antibodies may represent potential treatment strategies to treat COVID-19 in CMML patients [4].

Abbreviations: ARDS, acute respiratory distress syndrome; CBC, complete blood count; CMML, chronic myelomonocytic leukemia; COVID-19, coronavirus disease 2019; FN, febrile neutropenia; G-CSF, granulocyte-colony stimulating factor; RT-PCR, reverse transcription polymerase chain reaction; SARS-CoV-2, severe acute respiratory syndrome novel coronavirus-2.

Blood Res 2020;55:278~281 https://doi.org/10.5045/br.2020.2020230