Some Cancer Patients at Higher Risk for COVID-19

Like all cancer patients, Carol Andrade is taking special precautions during the COVID-19 pandemic. But Ms. Andrade, 70, must be hypervigilant because she belongs to a subset of patients who are at extremely high risk for the virus ― those with significantly compromised immune systems.

A leukemia patient, Ms. Andrade underwent an allogeneic stem cell transplantation at Miami Cancer Institute in July 2019, receiving her transplant from an unrelated donor. Shortly before coronavirus began to spread, she had been cleared to resume some activities, such as eating out. Now she is staying home.

“With all the precautions we take, Carol managed to catch a mild cold, which I eventually got,” said her partner, Stella Stitsky. “It took me about 10 days to recover, but it took Carol a month to completely get her symptoms to disappear.”

Testing proved that Ms. Andrade’s cold was a result of coronavirus HKU1, that causes the common cold ― not COVID-19. Her delayed recovery also convinced her that she is still very vulnerable.

“Patients who are on any type of immunosuppressant therapy or have had a stem cell transplant are the most vulnerable to infection,” said Guenther Koehne, M.D., Ph.D., deputy director and chief of Blood and Marrow Transplant, Hematologic Oncology and Benign Hematology at Miami Cancer Institute (pictured at left). “There is no proven treatment yet for COVID-19 and it could quite possibly be catastrophic for these patients.”

Precaution Tips

Stem cell patients and those with leukemia, multiple myeloma and other blood cancers that require chemotherapy and/or radiation treatment that weakens or destroys the immune system, are trained well in protective measures, Dr. Koehne said. Their daily routine involves staying home and/or social distancing (even within the household), avoiding sick people, using a mask and gloves when appropriate, hand washing, avoiding touching the face and cleaning surfaces diligently.

But because many people with COVID-19 have no or mild symptoms and can spread the virus days before they realize they are sick, Dr. Koehne cautions patients to take whatever steps are necessary to stay well. “The more vigilant, the better,” he said. “If someone in the household is an essential employee who comes in and out, going to and from work or elsewhere, you may want to consider staying separate from them at this time.”

While a stem cell patient is at highest risk for an infection in the three to six months following their transplant, their immune system may remain weak for up to a year, sometimes even longer. Each patient is different and blood tests help doctors determine when it is safe for patients to resume activities.

Virtual Health Programs

To help patients, caregivers and the community deal with home confinement ― especially during the COVID-19 pandemic ― Miami Cancer Institute is offering free, virtual programs on everything from supporting the immune system to meditation and exercise to nutrition and cooking tips. There’s even a yoga with your dog class. To sign up, click here or go to MiamiCancerInstitute.com, scroll to the bottom of the page and click on “Subscribe Now” in the Join the Community heading.

Information for Current Patients

Some patients may be wondering if their scheduled stem cell transplant will still occur. Every cancer facility is different, but the team at Miami Cancer Institute is working diligently to ensure patients receive treatment. It may mean adjusting or briefly delaying their transplant, however. “Donor cells come to us from all over the world,” Dr. Koehne said. “They are delivered personally via courier. With travel restrictions and fewer flight options, COVID-19 has definitely made this more complex.”

The Institute is following the recommendations of the National Marrow Donor Program (NMDP) and waiting to receive donor cells first, before hospitalizing the patient for the chemotherapy and radiation that prepares their body for the transplant. The donor stem cells are now cryopreserved before use.

COVID-19 is not known to spread through the blood, so the blood supply and donor cells are considered safe. Donations are needed and strongly encouraged. For more information for patients and donors, go to the FAQ-COVID-19 section at Be The Match.

Because every individual’s circumstance is different, please connect with your oncologist or medical provider for answers to specific questions related to your cancer care. For the latest updates on Baptist Health South Florida and Miami Cancer Institute COVID-19 news, click here.

Information specific to Miami Cancer Institute patients

• Stem cell transplant patients have a designated entrance to the Miami Cancer Institute Research Building.
• Follow your doctor’s instructions about safety precautions.
• All patients are screened upon entrance. Caregivers and providers are regularly screened.
• Any cancer patient who is ill or has symptoms including fever, cough or shortness of breath should call their physician immediately.
• Virtual classes ― from exercise and meditation to nutrition and support groups ― are available by signing up here. Or go to MiamiCancerInstitute.com, scroll to the bottom of the page and click on “Subscribe Now” in the Join the Community heading.