Table 5.

Proposed recommendations for lymphoma and myeloma in COVID afflicted areas/hospitals

Aggressive non-Hodgkins lymphoma	High priority	Omit bone marrow as a staging investigation if whole-body PET is done [49] Standard RCHOP/CHOP for newly diagnosed patients of DLBCL/PMBCL/double-hit lymphomas/T cell lymphoma, Omit RT after 4 RCHOP in limited stage disease [39, 50] DA-EPOCH-R for burkitt lymphoma [38]
	Intermediate priority	Omit high dose methotrexate as CNS prophylaxis, continue intra-thecal methotrexate with each cycle [41] Salvage regimes that can be delivered easily on out-patient (e.g. R-GCVP) can be used for relapsed disease in transplant eligible patients [50, 51]
	Low priority	Oral metronomic therapy ± lenalidomide/palliation for relapsed/refractory disease Omit end of treat PET if interim PET was in CR [42]
Indolent non-Hodgkins lymphoma	High priority	Treat only organ threatening disease Oral ibrutinib/R-chlorambucil/R-CVP/R-monotherapy/chlorambucil-prednisolone over BR for organ threatening disease [43]
	Intermediate priority	Omit maintenance rituximab and immunoglobulin replacement [43]
	Low priority	Postpone surveillance visits in asymptomatic patients Autologous transplants in CR1 for Mantle Cell Lymphoma  maybe deferred
Hodgkins lymphoma	High priority	Early favourable-ABVD × 4, omit IFRT if PET negative Early unfavourable-ABVD × 4–6 Advanced-ABVD × 6 De-escalate to AVD if interim PET is negative [44, 52]
	Intermediate priority	Refer to non COVID hospitals for autologous transplant if asymptomatic/late relapse [44]
	Low priority	In relapsed/refractory disease, prefer regimens that can be given as outpatient therapy (like GDP) for transplant eligible patients [44] Oral metronomic therapy for transplant in-eligible patients
Multiple myeloma and plasma cell dyscrasias	High priority	Standard 3-drug induction therapy in NDMM Doublet therapy for frail/elderly individuals Treat only patients with CRAB criteria, SLiM may wait Give first dose of anti-resorptive therapy [47, 48]
	Intermediate priority	Postpone all transplants Shift to lenalidomide maintenance after 6–8 cycles, stem cells maybe cryopreserved in transplant eligible patients [48]
	Low priority	Reduce follow up and monitoring of MGUS and smoldering myeloma Frequency of anti-resorptive therapy may be shifted to 3 monthly instead of monthly