Table 2.

Considerations while caring for leukemic patients during the COVID-19 pandemic

Preventive measures	Supportive measures	Treatment modifications
• Wearing masks and gloves, social distancing, and frequent hand washing • Limited inpatient visitation • Adequate signage • Minimize labs • More telehealth/telephone visits	• Prophylactic antimicrobials when neutropenic • Growth factors for highly myelosuppressive regimens and during infections, when indicated • Anticoagulation: when inpatient, when on asparaginase • Low threshold for blood transfusions (e.g., hemoglobin <7.5 gm/dL) [38], anti-fibrinolytic agents for platelet refractory patients	• Await results of cytogenetics and mutation analysis before therapy • Use less intensive therapies • Oral targeted agents and outpatient regimens whenever possible • Factor-in transfusion and labs requirements in addition to monitoring for toxicities with each regimen • Omit maintenance if in molecular remission • Avoid growth factors in severe COVID-19 infection