The new world: hematopoietic stem cell transplant during a pandemic

Abstract

Purpose of review Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) impacted every facet of hematopoietic cell transplantation. This article reviews the adjustments to recipient and donor care that occurred in response to this unprecedented event. Recent findings Transplant centers modified algorithms, patient flow, education, and how we provided care. Our donor center partners reworked how donors were evaluated and products delivered to the transplant center. Our professional societies provided guidelines for patient and donor care and rapidly modified these based upon the never-ending stream of new data learned about SARS-CoV-2. Our research organizations provided rapid analyses to ensure the care modifications necessitated did not have a profound negative impact on our patients or donors. Summary The efforts of transplant providers and donor centers worldwide allowed patients to receive the transplant needed with assurances that they were receiving the best care available despite the worldwide challenge.

COVID-19 and HSCT (Hematopoietic stem cell transplant)

“…In this same era, broad recommendations and policies for SARS-CoV-2 screening of recipients and donors with deferral periods for individuals testing positive were codified, in an effort to mitigate risk both to individual patients and more broadly risk for transmission in the healthcare setting [ 13 , 14 ]. Admittedly, the screening protocols and management algorithms with regard to deferral timeline in the case of a positive test, in particular in a potential donor, are not “data driven.” While there is evidence of donor-derived COVID-19 transmitted by lung transplantation [ 15 , 16 ], there is to date no confirmed instance of transmission via cellular transplant [ 17 ].…”

“…ǂ variable definition of severe disease, *variable follow-up time. Author, site(s) Diagnosis period # HSCT recipients: auto/allo/CAR-T Age, years – median (range) Time since HSCT or CAR-T – median (range) % asymptomatic % hospitalized % required supplemental O2 % required ICU care % require mechanical ventilation % severe COVID ǂ % COVID-specific mortality* % overall mortality* % mortality (by time from diagnosis) Altuntas, Republic of Turkey (Ministry of Health database) 3/11/20–5/29/20 32: 20/12/0 56.5 [ [17] , [18] , [19] ] 100 22 16 22 16 Coll, Spain (national)*not all lab confirmed on or before 7/13/20 113: 42/71/0 Auto:60 [ [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] ] 18 months [ [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] ...…”