AGIHO guideline on evidence-based management of COVID-19 in cancer patients: 2022 update on vaccination, pharmacological prophylaxis and therapy in light of the omicron variants

Nicola Giesen; Elena Busch; Enrico Schalk; Gernot Beutel; Maria M Rüthrich; Marcus Hentrich; Bernd Hertenstein; Hans H Hirsch; Meinolf Karthaus; Yascha Khodamoradi; Philipp Koehler; William Krüger; Michael Koldehoff; Robert Krause; Sibylle C Mellinghoff; Olaf Penack; Michael Sandherr; Ruth Seggewiss-Bernhardt; Karsten Spiekermann; Rosanne Sprute; Jannik Stemler; Florian Weissinger; Bernhard Wörmann; Hans-Heinrich Wolf; Oliver A Cornely; Christina T Rieger; Marie von Lilienfeld-Toal

doi:10.1016/j.ejca.2022.11.030

AGIHO guideline on evidence-based management of COVID-19 in cancer patients: 2022 update on vaccination, pharmacological prophylaxis and therapy in light of the omicron variants

Eur J Cancer. 2023 Mar:181:102-118. doi: 10.1016/j.ejca.2022.11.030. Epub 2022 Dec 10.

Authors

Nicola Giesen¹, Elena Busch², Enrico Schalk³, Gernot Beutel⁴, Maria M Rüthrich⁵, Marcus Hentrich⁶, Bernd Hertenstein⁷, Hans H Hirsch⁸, Meinolf Karthaus⁹, Yascha Khodamoradi¹⁰, Philipp Koehler¹¹, William Krüger¹², Michael Koldehoff¹³, Robert Krause¹⁴, Sibylle C Mellinghoff¹⁵, Olaf Penack¹⁶, Michael Sandherr¹⁷, Ruth Seggewiss-Bernhardt¹⁸, Karsten Spiekermann¹⁹, Rosanne Sprute¹⁵, Jannik Stemler¹⁵, Florian Weissinger²⁰, Bernhard Wörmann²¹, Hans-Heinrich Wolf²², Oliver A Cornely²³, Christina T Rieger²⁴, Marie von Lilienfeld-Toal²⁵

Affiliations

¹ Department of Hematology, Oncology and Palliative Care, Robert Bosch Hospital, Stuttgart, Germany. Electronic address: nicola.giesen@rbk.de.
² Department of Medical Oncology, National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany.
³ Department of Hematology and Oncology, Medical Centre, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
⁴ Department for Haematology, Haemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany; Working Party Intensive Care in Haematologic and Oncologic Patients (iCHOP) of the German Society of Haematology and Medical Oncology (DGHO), Germany.
⁵ Department of Interdisciplinary Intensive Care Medicine, Vivantes Humboldt-Klinikum, Berlin, Germany.
⁶ Department of Hematology and Oncology, Red Cross Hospital Munich, Munich, Germany.
⁷ Klinikum Bremen-Mitte, Bremen, Germany.
⁸ Transplantation & Clinical Virology, Department Biomedicine (Haus Petersplatz), University of Basel, Basel, Switzerland; Clinical Virology, Laboratory Medicine, University Hospital Basel, Basel, Switzerland; Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Basel, Switzerland.
⁹ Department of Hematology, Oncology and Palliative Care, Klinikum Neuperlach/Klinikum Harlaching, Munich, Germany.
¹⁰ Department of Internal Medicine, Infectious Diseases, Goethe University Frankfurt, Frankfurt Am Main, Germany.
¹¹ University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany.
¹² Department of Hematology and Oncology, Stem Cell Transplantation, Palliative Care, University Hospital Greifswald, Greifswald, Germany.
¹³ Department of Bone Marrow Transplantation, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Department of Hygiene and Environmental Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
¹⁴ Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
¹⁵ University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
¹⁶ Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Hematology, Oncology and Tumorimmunology, Berlin, Germany.
¹⁷ MVZ Penzberg, Department of Hematology and Oncology, Weilheim, Germany.
¹⁸ Medizinische Klinik V, Sozialstiftung Bamberg, Bamberg, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany.
¹⁹ Department of Medicine III, University Hospital, LMU Munich, Munich, Germany.
²⁰ Department of Internal Medicine, Hematology, Oncology, Stem Cell Transplantation and Palliative Care, Evangelisches Klinikum Bethel, Bielefeld, Germany.
²¹ Division of Haematology, Oncology and Tumor Immunology, Department of Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.
²² Department of Hematology, Oncology and Hemostaseology, Südharzklinikum Nordhausen, Nordhausen, Germany.
²³ University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany.
²⁴ Hemato-Oncology Germering & Interdisciplinary Tumorcenter, Ludwig-Maximilians-University Munich, Munich, Germany.
²⁵ Department of Haematology and Medical Oncology, Clinic for Internal Medicine II, University Hospital Jena, Jena, Germany; Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany.

Abstract

The novel coronavirus SARS-CoV-2 and the associated infectious disease COVID-19 pose a significant challenge to healthcare systems worldwide. Patients with cancer have been identified as a high-risk population for severe infections, rendering prophylaxis and treatment strategies for these patients particularly important. Rapidly evolving clinical research, resulting in the recent advent of various vaccines and therapeutic agents against COVID-19, offers new options to improve care and protection of cancer patients. However, ongoing epidemiological changes and rise of new virus variants require repeated revisions and adaptations of prophylaxis and treatment strategies to meet these new challenges. Therefore, this guideline provides an update on evidence-based recommendations with regard to vaccination, pharmacological prophylaxis and treatment of COVID-19 in cancer patients in light of the currently dominant omicron variants. It was developed by an expert panel of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO) based on a critical review of the most recent available data.

Keywords: COVID-19; Cancer; Guideline; Haematological malignancy; Prophylaxis; SARS-CoV-2; Solid tumour; Treatment; Vaccination.

Publication types

Review

MeSH terms

COVID-19* / complications
COVID-19* / prevention & control
Communicable Diseases* / complications
Communicable Diseases* / drug therapy
Humans
Neoplasms* / drug therapy
Neoplasms* / therapy
SARS-CoV-2
Vaccination

Supplementary concepts

SARS-CoV-2 variants