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5. Life-prolonging treatment restrictions and outcomes in patients with cancer and COVID-19:an update from the Dutch Oncology COVID-19 Consortium

Author

de Joode, Karlijn, Tol, Jolien, Hamberg, Paul, Cloos, Marissa, Kastelijn, Elisabeth A., Borgers, Jessica S.W., Nuij, Veerle J.A.A., Klaver, Yarne, Herder, Gerarda J.M., Mutsaers, Pim G.N.J., Dumoulin, Daphne W., Oomen-de Hoop, Esther, van Diemen, Nico G.J., Libourel, Eduard J., Geraedts, Erica J., Bootsma, Gerben P., van der Leest, Cor H., Peerdeman, Anne L., Herbschleb, Karin H., Visser, Otto J., Bloemendal, Haiko J., van Laarhoven, Hanneke W.M., de Vries, Elisabeth G.E., Hendriks, Lizza E.L., Beerepoot, Laurens V., Westgeest, Hans M., van den Berkmortel, Franchette W.P.J., Dingemans, Anne Marie C., van der Veldt, Astrid A.M., van Leeuwen, L., van der Meer, F. S., Tiemessen, M. A., van Diepen, D. M., Brocken, P., Drooger, J. C., de Groot, J. W.B., Stigt, J. A., Slingerland, M., Haberkorn, B. C.M., Aarts, M. J.B., Youssef, M., Faber, L. M., van de Wetering, R. A.W., Bard, M. P.L., Douma, G., Suijkerbuijk, K. P.M., Bakker, S. D., de Jong, W. K., Staal, A. J., Franken, B., de Joode, Karlijn, Tol, Jolien, Hamberg, Paul, Cloos, Marissa, Kastelijn, Elisabeth A., Borgers, Jessica S.W., Nuij, Veerle J.A.A., Klaver, Yarne, Herder, Gerarda J.M., Mutsaers, Pim G.N.J., Dumoulin, Daphne W., Oomen-de Hoop, Esther, van Diemen, Nico G.J., Libourel, Eduard J., Geraedts, Erica J., Bootsma, Gerben P., van der Leest, Cor H., Peerdeman, Anne L., Herbschleb, Karin H., Visser, Otto J., Bloemendal, Haiko J., van Laarhoven, Hanneke W.M., de Vries, Elisabeth G.E., Hendriks, Lizza E.L., Beerepoot, Laurens V., Westgeest, Hans M., van den Berkmortel, Franchette W.P.J., Dingemans, Anne Marie C., van der Veldt, Astrid A.M., van Leeuwen, L., van der Meer, F. S., Tiemessen, M. A., van Diepen, D. M., Brocken, P., Drooger, J. C., de Groot, J. W.B., Stigt, J. A., Slingerland, M., Haberkorn, B. C.M., Aarts, M. J.B., Youssef, M., Faber, L. M., van de Wetering, R. A.W., Bard, M. P.L., Douma, G., Suijkerbuijk, K. P.M., Bakker, S. D., de Jong, W. K., Staal, A. J., and Franken, B.

Abstract

Aim of the study: The coronavirus disease 2019 (COVID-19) pandemic significantly impacted cancer care. In this study, clinical patient characteristics related to COVID-19 outcomes and advanced care planning, in terms of non-oncological treatment restrictions (e.g. do-not-resuscitate codes), were studied in patients with cancer and COVID-19. Methods: The Dutch Oncology COVID-19 Consortium registry was launched in March 2020 in 45 hospitals in the Netherlands, primarily to identify risk factors of a severe COVID-19 outcome in patients with cancer. Here, an updated analysis of the registry was performed, and treatment restrictions (e.g. do-not-intubate codes) were studied in relation to COVID-19 outcomes in patients with cancer. Oncological treatment restrictions were not taken into account. Results: Between 27th March 2020 and 4th February 2021, 1360 patients with cancer and COVID-19 were registered. Follow-up data of 830 patients could be validated for this analysis. Overall, 230 of 830 (27.7%) patients died of COVID-19, and 60% of the remaining 600 patients with resolved COVID-19 were admitted to the hospital. Patients with haematological malignancies or lung cancer had a higher risk of a fatal outcome than other solid tumours. No correlation between anticancer therapies and the risk of a fatal COVID-19 outcome was found. In terms of end-of-life communication, 50% of all patients had restrictions regarding life-prolonging treatment (e.g. do-not-intubate codes). Most identified patients with treatment restrictions had risk factors associated with fatal COVID-19 outcome. Conclusion: There was no evidence of a negative impact of anticancer therapies on COVID-19 outcomes. Timely end-of-life communication as part of advanced care planning could save patients from prolonged suffering and decrease burden in intensive care units. Early discussion of treatment restrictions should therefore be part of routine oncological care, especially during the COVID-19 pandemic.

Published
2022

6. Life-prolonging treatment restrictions and outcomes in patients with cancer and COVID-19: an update from the Dutch Oncology COVID-19 Consortium

Author

MS Medische Oncologie, Infection & Immunity, Cancer, Longziekten, de Joode, Karlijn, Tol, Jolien, Hamberg, Paul, Cloos, Marissa, Kastelijn, Elisabeth A., Borgers, Jessica S.W., Nuij, Veerle J.A.A., Klaver, Yarne, Herder, Gerarda J.M., Mutsaers, Pim G.N.J., Dumoulin, Daphne W., Oomen-de Hoop, Esther, van Diemen, Nico G.J., Libourel, Eduard J., Geraedts, Erica J., Bootsma, Gerben P., van der Leest, Cor H., Peerdeman, Anne L., Herbschleb, Karin H., Visser, Otto J., Bloemendal, Haiko J., van Laarhoven, Hanneke W.M., de Vries, Elisabeth G.E., Hendriks, Lizza E.L., Beerepoot, Laurens V., Westgeest, Hans M., van den Berkmortel, Franchette W.P.J., Haanen, John B.A.G., Dingemans, Anne Marie C., van der Veldt, Astrid A.M., Becker-Commissaris, A., Terheggen, F., van den Borne, B. E.E.M., van Warmerdam, L. J.C., van Leeuwen, L., van der Meer, F. S., Tiemessen, M. A., van Diepen, D. M., Strobbe, L., Koekkoek, J. A.F., Brocken, P., Drooger, J. C., de Groot, J. W.B., Aarts, M. J.B., Cirkel, G. A., Claessens, N. J.M., Jalving, M., Suijkerbuijk, K. P.M., van Lindert, A. S.R., Bakker, S. D., MS Medische Oncologie, Infection & Immunity, Cancer, Longziekten, de Joode, Karlijn, Tol, Jolien, Hamberg, Paul, Cloos, Marissa, Kastelijn, Elisabeth A., Borgers, Jessica S.W., Nuij, Veerle J.A.A., Klaver, Yarne, Herder, Gerarda J.M., Mutsaers, Pim G.N.J., Dumoulin, Daphne W., Oomen-de Hoop, Esther, van Diemen, Nico G.J., Libourel, Eduard J., Geraedts, Erica J., Bootsma, Gerben P., van der Leest, Cor H., Peerdeman, Anne L., Herbschleb, Karin H., Visser, Otto J., Bloemendal, Haiko J., van Laarhoven, Hanneke W.M., de Vries, Elisabeth G.E., Hendriks, Lizza E.L., Beerepoot, Laurens V., Westgeest, Hans M., van den Berkmortel, Franchette W.P.J., Haanen, John B.A.G., Dingemans, Anne Marie C., van der Veldt, Astrid A.M., Becker-Commissaris, A., Terheggen, F., van den Borne, B. E.E.M., van Warmerdam, L. J.C., van Leeuwen, L., van der Meer, F. S., Tiemessen, M. A., van Diepen, D. M., Strobbe, L., Koekkoek, J. A.F., Brocken, P., Drooger, J. C., de Groot, J. W.B., Aarts, M. J.B., Cirkel, G. A., Claessens, N. J.M., Jalving, M., Suijkerbuijk, K. P.M., van Lindert, A. S.R., and Bakker, S. D.

Published
2022

7. Life-prolonging treatment restrictions and outcomes in patients with cancer and COVID-19: an update from the Dutch Oncology COVID-19 Consortium

Author

de Joode, Karlijn, primary, Tol, Jolien, additional, Hamberg, Paul, additional, Cloos, Marissa, additional, Kastelijn, Elisabeth A., additional, Borgers, Jessica S.W., additional, Nuij, Veerle J.A.A., additional, Klaver, Yarne, additional, Herder, Gerarda J.M., additional, Mutsaers, Pim G.N.J., additional, Dumoulin, Daphne W., additional, Oomen-de Hoop, Esther, additional, van Diemen, Nico G.J., additional, Libourel, Eduard J., additional, Geraedts, Erica J., additional, Bootsma, Gerben P., additional, van der Leest, Cor H., additional, Peerdeman, Anne L., additional, Herbschleb, Karin H., additional, Visser, Otto J., additional, Bloemendal, Haiko J., additional, van Laarhoven, Hanneke W.M., additional, de Vries, Elisabeth G.E., additional, Hendriks, Lizza E.L., additional, Beerepoot, Laurens V., additional, Westgeest, Hans M., additional, van den Berkmortel, Franchette W.P.J., additional, Haanen, John B.A.G., additional, Dingemans, Anne-Marie C., additional, van der Veldt, Astrid A.M., additional, Becker-Commissaris, A., additional, Terheggen, F., additional, van den Borne, B.E.E.M., additional, van Warmerdam, L.J.C., additional, van Leeuwen, L., additional, van der Meer, F.S., additional, Tiemessen, M.A., additional, van Diepen, D.M., additional, Strobbe, L., additional, Koekkoek, J.A.F., additional, Brocken, P., additional, Drooger, J.C., additional, Heller, R., additional, de Groot, J.W.B., additional, Stigt, J.A., additional, Pitz, C.C.M., additional, Slingerland, M., additional, Borm, F.J., additional, Haberkorn, B.C.M., additional, van 't Westeinde, S.C., additional, Aarts, M.J.B., additional, van Putten, J.W.G., additional, Youssef, M., additional, Cirkel, G.A., additional, van Rooijen, C.R., additional, Citgez, E., additional, Barlo, N.P., additional, Scholtes, B.M.J., additional, Koornstra, R.H.T., additional, Claessens, N.J.M., additional, Faber, L.M., additional, Rikers, C.H., additional, van de Wetering, R.A.W., additional, Veurink, G.L., additional, Bouter, B.W., additional, Houtenbos, I., additional, Bard, M.P.L., additional, Douma, G., additional, Jalving, M., additional, Hiltermann, T.J.N., additional, Schuurbiers-Siebers, O.C.J., additional, Suijkerbuijk, K.P.M., additional, van Lindert, A.S.R., additional, van de Wouw, A.J., additional, van den Boogaart, V.E.M., additional, Bakker, S.D., additional, Looysen, E., additional, de Jong, W.K., additional, Siemerink, E.J.M., additional, Staal, A.J., additional, Franken, B., additional, and van Geffen, W.H., additional

Published
2022
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13. High factor VIII plasma levels as a risk factor for venous thrombosis: no evidence of inheritance from a family cohort study

Author

Libourel, Eduard J., Baljé-Volkers Degrees, Corine P., Hamulyàk, Karly, Prins, Martin H., Middeldorp, Saskia, Büller, Harry R., van der Meer, Jan, and Vascular Medicine

Subjects
congenital, hereditary, and neonatal diseases and abnormalities, animal diseases, hemic and lymphatic diseases
Abstract

We assessed inheritance of high factor VIII:C (FVIII:C greater than or equal to150%) levels in 52 probands carrying factor V Leiden and 176 first-degree relatives. Although age-adjusted FVIII:C levels aggregated within families, relatives of probands with FVIII:C levels greater than or equal to150% and

Published
2004

14. Co-segregation of thrombophilic disorders in factor V Leiden carriers; the contributions of factor VIII, factor XI, thrombin activatable fibrinolysis inhibitor and lipoprotein(a) to the absolute risk of venous thromboembolism

Author

Libourel, Eduard J., Bank, Ivan, Meinardi, Johan R., Baljé -Volkers, Corinne P., Hamulyak, Karly, Middeldorp, Saskia, Koopman, Maria M. W., van Pampus, Elisabeth C. M., Prins, Martin H., Büller, Harry R., van der Meer, Jan, Faculteit Medische Wetenschappen/UMCG, Restoring Organ Function by Means of Regenerative Medicine (REGENERATE), Groningen Kidney Center (GKC), and Vascular Medicine

Subjects
DEFICIENCY, factor VIII : C, factor XI : C, TAFl, lipoprotein (a), PROTEIN-C, venous thrombosis, DEEP-VEIN THROMBOSIS, MUTATION, RESISTANCE, FAMILY MEMBERS
Abstract

Background and Objectives. The clinical expression of factor V Leiden varies widely within and between families and only a minority of carriers will ever develop venous thromboembolism. Co-segregation of thrombophilic disorders is a possible explanation, Our aim was to assess the contributions of high levels of factor VIII:C, factor XI:C, thrombin activatable fibrinolysis inhibitor (TAFI) and lipoprotein (a) (Lp(a)) to the risk of venous thromboembolism in factor V Leiden carriers. Design and Methods. Levels of the four proteins were measured, in addition to tests of deficiencies for antithrombin, protein C and protein S, and the prothrombin G20210A mutation, in 153 factor V Leiden carriers, derived from a family cohort study. The (adjusted) relative risk and absolute risk of venous thromboembolism for high levels of each protein were calculated. Results. Of carriers, 60% had one or more concomitant thrombophilic disorders. Crude odds ratios (95% Cl) of venous thromboembolism for high protein levels were: 3.2 (1.1-9.3) (factor VIII:C); 1.7 (0.6-4.9) (factor XI:C); 3.0 (1.1-8.2) (TAFI); and 1.9 (0.7-5.7) (Lp(a)). Adjusted for age, sex, other concomitant thrombophilic disorders and exogenous risk factors, the odds ratio for venous thromboembolism were 2.7 (0.8-8.7) for high factor VIII:C levels and 1.8 (0.6-5.3) for high TAFI levels. Annual incidences in subgroups of carriers were 0.35% (0.09-0.89), 0.44% (0.05-1.57) and 0.94% (0.35-2.05) for concomitance of high levels of factor VIII:C, TAR and both, respectively, as compared to 0.09% (0.00-0.48) in single factor V Leiden carriers and 1.11% (0.30-2.82) for other concomitant disorders. Interpretation and Conclusions. High levels of factor VIII:C and TAFI, in contrast with factor XI:C and Lp(a), are mild risk factors for venous thromboembolism, and substantially contribute to the risk of venous thromboembolism in factor V Leiden carriers. Our data support the hypothesis that the clinical expression of factor V Leiden depends on co-segregation of thrombophilic disorders. (C) 2002, Ferrata Storti Foundation.

Published
2002

15. Platelet Doubling After the First Azacitidine Cycle Is a Promising Predictor for Response in MDS, CMML and AML Patients in the Dutch Azacitidine Compassionate Patient Named Program,

Author

Huls, Geert A, primary, van der Helm, Lieke H., additional, Alhan, Canan, additional, Wijermans, P.W., additional, van Marwijk Kooy, Marinus, additional, Schaafsma, Martijn R., additional, Biemond, Bart J, additional, Beeker, Aart, additional, Hoogendoorn, Mels, additional, van Rees, Bastiaan P., additional, de Weerdt, Okke, additional, Wegman, Jurgen, additional, Libourel, Eduard J, additional, Luykx-de Bakker, Sylvia A., additional, Minnema, Monique C., additional, Brouwer, Rolf, additional, Croon-de Boer, Fransien, additional, Eefting, Matthias, additional, Jie, Kon-Siong G., additional, van der Loosdrecht, Arjan A., additional, Koedam, Jan, additional, Veeger, Nic J.G.M., additional, and Vellenga, Edo, additional

Published
2011
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18. Prothrombin 20210A Mutation

Author

Bank, Ivan, primary, Libourel, Eduard J., additional, Middeldorp, Saskia, additional, van Pampus, Elisabeth C. M., additional, Koopman, Maria M. W., additional, Hamulyák, Karly, additional, Prins, Martin H., additional, van der Meer, Jan, additional, and Büller, Harry R., additional

Published
2004
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21. Co-segregation of thrombophilic disorders in factor V Leiden carriers; the contributions of factor VIII, factor XI, thrombin activatable fibrinolysis inhibitor and lipoprotein(a) to the absolute risk of venous thromboembolism.

Author

Libourel EJ, Bank I, Meinardi JR, Baljé -Volkers CP, Hamulyak K, Middeldorp S, Koopman MM, van Pampus EC, Prins MH, Büller HR, and van der Meer J

Subjects
Adult, Aged, Aged, 80 and over, Carboxypeptidase B2 biosynthesis, Cohort Studies, Factor VIII biosynthesis, Factor XI biosynthesis, Female, Humans, Lipoprotein(a) blood, Male, Middle Aged, Risk Factors, Thrombosis etiology, Venous Thrombosis etiology, Carboxypeptidase B2 genetics, Factor V biosynthesis, Factor V genetics, Factor VIII genetics, Factor XI genetics, Lipoprotein(a) genetics, Thrombosis diagnosis, Venous Thrombosis diagnosis
Abstract

Background and Objectives: The clinical expression of factor V Leiden varies widely within and between families and only a minority of carriers will ever develop venous thromboembolism. Co-segregation of thrombophilic disorders is a possible explanation. Our aim was to assess the contributions of high levels of factor VIII:C, factor XI:C, thrombin activatable fibrinolysis inhibitor (TAFI) and lipoprotein (a) (Lp(a)) to the risk of venous thromboembolism in factor V Leiden carriers., Design and Methods: Levels of the four proteins were measured, in addition to tests of deficiencies for antithrombin, protein C and protein S, and the prothrombin G20210A mutation, in 153 factor V Leiden carriers, derived from a family cohort study. The (adjusted) relative risk and absolute risk of venous thromboembolism for high levels of each protein were calculated., Results: Of carriers, 60% had one or more concomitant thrombophilic disorders. Crude odds ratios (95% CI) of venous thromboembolism for high protein levels were: 3.2 (1.1-9.3) (factor VIII:C); 1.7 (0.6-4.9) (factor XI:C); 3.0 (1.1-8.2) (TAFI); and 1.9 (0.7-5.7) (Lp(a)). Adjusted for age, sex, other concomitant thrombophilic disorders and exogenous risk factors, the odds ratio for venous thromboembolism were 2.7 (0.8-8.7) for high factor VIII:C levels and 1.8 (0.6-5.3) for high TAFI levels. Annual incidences in subgroups of carriers were 0.35% (0.09-0.89), 0.44% (0.05-1.57) and 0.94% (0.35-2.05) for concomitance of high levels of factor VIII:C, TAFI and both, respectively, as compared to 0.09% (0.00-0.48) in single factor V Leiden carriers and 1.11% (0.30-2.82) for other concomitant disorders., Interpretation and Conclusions: High levels of factor VIII:C and TAFI, in contrast with factor XI:C and Lp(a), are mild risk factors for venous thromboembolism, and substantially contribute to the risk of venous thromboembolism in factor V Leiden carriers. Our data support the hypothesis that the clinical expression of factor V Leiden depends on co-segregation of thrombophilic disorders.

Published
2002

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