TABLE 2.

Practical recommendations for the management of patients with lymphoma and COVID‐19

COVID‐19 disease status
		Unexposed	Exposed	With mild/moderate COVID‐19 (outpatient)	With severe/critical COVID‐19 (hospitalized)	With history of COVID‐19
Setting of lymphoma management	Diagnosis	Protect from exposure Vaccinate a Start pre‐exposure or primary prophylaxis with tixagevimab‐cilgavimab b , if available	SARS‐CoV‐2 testing c Start post‐exposure prophylaxis with monoclonal antibodies, if available	Hold any procedure until resolution of COVID‐19 signs and symptoms and negative SARS‐CoV‐2 test If antineoplastic treatment is urgently needed (aggressive lymphoma), consider chemotherapy alone Start COVID‐19 treatment d as early as possible	Hold any procedure until resolution of COVID‐19 signs and symptoms and negative SARS‐CoV‐2 antigen test Treat COVID‐19 and COVID‐19‐related organ failure d	Vaccinate a if > 120 days elapsed from COVID‐19 resolution Start prophylaxis with tixagevimab‐cilgavimab b as soon as possible
	Treatment or ≤6 months since treatment completion	Protect from exposure Vaccinate a Start primary prophylaxis with tixagevimab‐cilgavimab b	SARS‐CoV‐2 testing c Start post‐exposure prophylaxis with monoclonal antibodies, if available	Hold antineoplastic treatment until resolution of COVID‐19 signs and symptoms and negative test for SARS‐CoV‐2 Consider to stop anti‐CD20 therapy If antineoplastic treatment is urgently needed (aggressive lymphoma), consider chemotherapy alone Start COVID‐19 treatment d as early as possible	Hold antineoplastic treatment until resolution of COVID‐19 signs and symptoms and negative antigen test for SARS‐CoV‐2 Stop anti‐CD20 therapy Treat COVID‐19 and COVID‐19‐related organ failure d	Vaccinate a if > 120 days elapsed from COVID‐19 resolution Start prophylaxis with tixagevimab‐cilgavimab b as soon as possible, if available
	Follow‐up	Protect from exposure Vaccinate a	SARS‐CoV‐2 testing	Start COVID‐19 treatment d as early as possible	Treat COVID‐19 and COVID‐19‐related organ failure d	Vaccinate a if > 120 days elapsed from COVID‐19 resolution

^a According to the latest national/international recommendations for vaccination and for booster doses in immunocompromized subjects (e.g.,: SIE‐GITMO guideline 2021) ⁸⁶ .

^b Treatment should be administered according to tixagevimab‐cilgavimab label ⁶⁵ .

^c According to the latest national/international guidelines ⁸⁷ .

^d According to COVID‐19 severity and to the latest national/international recommendations for COVID‐19 treatment, for example,: WHO Living guidance for clinical management of COVID‐19 ⁸⁸ and NIH ⁸⁹ .