{"doi":"10.1002/ajh.25851","title":"Management of <scp>CLL</scp> patients early in the <scp>COVID</scp>‐19 pandemic: An international survey of <scp>CLL</scp> experts","abstract":"The coronavirus disease 2019 (COVID-19) pandemic caused by the novel coronavirus (SARS CoV-2) has posed an unprecedented health emergency, especially to those with older age or comorbid medical conditions.1 Patients with chronic lymphocytic leukemia (CLL) have a median age of about 70 years at diagnosis, and the majority suffer from additional medical comorbidities and immunosuppressed state.2 Therapeutic agents for CLL have immunomodulatory effects that can potentially alter the risk of contracting and the response to infection.3, 4 The interface of SARS-CoV-2 infection, severity of COVID-19 symptoms, and active treatment of CLL represents a major therapeutic dilemma—should CLL-directed therapy continue or be held? This is particularly true for patients receiving B-cell receptor kinase inhibitors, where abrupt treatment discontinuation can result in rapid decompensation in some patients that could mimic COVID-I9 symptoms. These overlapping syndromes bring forth another layer of complexity to the management of these high-risk CLL patients. Since the beginning of the COVID-19 pandemic, the CLL community has encountered many questions regarding primary prevention strategies, application of diagnostic tests for SARS CoV-2, and optimal management of CLL therapy in patients with COVID-19 illness. In the absence of clinical data guiding management of CLL in the setting of COVID-19, expert opinion is critical until ongoing and planned future studies provide high-quality data for evidence-based guidelines. We administered a survey to a cohort of CLL experts in the United States (US), Canada, Europe, and Australia on 25 March 2020, using QuestionPro software, a cloud-based online platform (Supplementary material). The survey included questions about expertsʼ baseline information and their recommendations on isolation, testing and CLL management in patients with CLL and COVID-19. Participants were selected from a database of physician experts chosen due to their published CLL research, and the focus of their clinical practice maintained by the CLL Society, a non-profit patient-focused and directed organization. Due to the time-sensitive nature of the topic, participants were only given 7 days to complete the online questionnaire. Descriptive results are presented in this report. Fisherʼs exact test was used to compare proportions of responses when applicable. The survey was sent to 62 CLL specialists, of whom 59 responded to at least one question, and 44 completed the survey for an overall response rate of 95% and a completion rate of 71%. Most responders were from the US (76%), followed by Europe (19%), Australia (3%), and Canada (2%). Participants were clinicians or clinician/scientists (50% each) and were from academic (90%), non-academic (5%) and governmental (5%) institutions. At the time of the survey completion, 14 experts (24%) had experience taking care of at least one CLL patient with confirmed COVID-19 (7% outpatient, 10% non-intensive care unit [ICU] service, 7% ICU). Regarding primary prevention and social distancing in patients with CLL compared to the general public, the choices and corresponding response rates were these. (a) Follow the recommendations from the World Health Organization (WHO) and the Center for Disease Control (CDC) as for the general public (32%). (b) The above plus having others do their essential chores such as grocery shopping or picking up medications (21%). (c) All the above plus refraining from even essential work if it involves contact with others (35%) and (d) All the above1-3 plus wearing an N-95 mask and gloves if they must leave the house (12%). There were multiple general comments about the importance of total isolation of patients with CLL during the COVID-19 pandemic, especially those on active treatment or with prior treatment for CLL. Local and federal recommendations have become stricter since the time of survey administration, making recommendations for the general public stricter and ","journal":"American Journal of Hematology","year":2020,"id":69054,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":21,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.968,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":233532,"name":"Anthony R. Mato","orcid":"0000-0001-8724-1875","position":1,"is_corresponding":false},{"id":35686,"name":"John C. Byrd","orcid":"0000-0001-9830-0711","position":2,"is_corresponding":false},{"id":366212,"name":"Alexey V. Danilov","orcid":"0000-0003-4461-0970","position":3,"is_corresponding":false},{"id":367825,"name":"Brad Hedrick","orcid":null,"position":4,"is_corresponding":false},{"id":233548,"name":"Chaitra S. Ujjani","orcid":"0000-0003-1977-1510","position":5,"is_corresponding":false},{"id":233533,"name":"Lindsey E. Roeker","orcid":"0000-0002-3806-059X","position":6,"is_corresponding":false},{"id":366213,"name":"Deborah M. Stephens","orcid":"0000-0001-9188-5008","position":7,"is_corresponding":false},{"id":233541,"name":"Matthew S. Davids","orcid":"0000-0003-4529-2003","position":8,"is_corresponding":false},{"id":366214,"name":"John M. Pagel","orcid":"0000-0001-5745-8125","position":9,"is_corresponding":false},{"id":233391,"name":"Mazyar Shadman","orcid":"0000-0002-3365-6562","position":10,"is_corresponding":false},{"id":366211,"name":"Brian Koffman","orcid":"0000-0001-8829-8283","position":0,"is_corresponding":true}],"reference_count":5,"raw_metadata":null,"created_at":"2026-07-18T21:42:22.705573Z","pmid":"32356356","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}