Impact of SARS-CoV-2 infection on graft composition and early transplant outcomes following allogeneic hematopoietic stem cell transplantation
Objective: To assess the feasibility of using donors with novel coronavirus disease 2019 (COVID-19) for allogeneic hematopoietic stem cell transplantation (allo-HSCT) when there are no other available donors and allo-HSCT cannot be delayed or discontinued. Methods: Seventy-one patients with malignant hematological diseases undergoing allo-HSCT between December 8, 2022, and January 10, 2023, were included. Of these, 16 received grafts from donors with mild COVID-19 (D-COVID(+) group) and 55 received grafts from donors without COVID-19 (D-COVID(-) group). The graft compositions were compared between the two groups. Engraftment, acute graft-versus-host disease (aGVHD), overall survival (OS), and relapse were also evaluated. Results: There were no serious side effects or adverse events in the D-COVID(+) group. The mononuclear cell dose and CD34(+) cell dose were comparable between the two groups, and no additional apheresis was required. There were no significant differences in the lymphocyte, monocyte, and T-cell subset doses between the two groups. The median natural killer cell dose in the D-COVID(+) group was significantly higher than that in the D-COVID(-) group (0.69×10(8)/kg vs. 0.53×10(8)/kg, P=0.031). The median follow-up time was 72 (33-104) days. All patients achieved primary engraftment. The 60-day platelet engraftment rates in the D-COVID(+) and D-COVID(-) groups were 100% and (96.4±0.2) %, respectively (P=0.568). There were no significant differences in neutrophil (P=0.309) and platelet (P=0.544) engraftment times. The cumulative incidence of grade 2-4 aGVHD was (37.5±1.6) % vs. (16.4±0.3) % (P=0.062), and of grade 3-4 aGVHD was 25.0% ±1.3% vs. 9.1% ±0.2% (P=0.095) in the D-COVID(+) and D-COVID(-) groups, respectively. The probabilities of 60-day OS were 100% and 98.1% ±1.8% (P=0.522) in the D-COVID(+) and D-COVID(-) groups, respectively. There was no relapse of primary disease during the study period. Conclusion: When allo-HSCT cannot be delayed or discontinued and no other donor is available, a donor with mild COVID-19 should be considered if tolerable. Larger sample sizes and longer follow-up periods are required to validate these results.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:44 |
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| Enthalten in: |
Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi - 44(2023), 11 vom: 14. Nov., Seite 890-899 |
| Sprache: |
Chinesisch |
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| Beteiligte Personen: |
Lin, F [VerfasserIn] |
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| Links: |
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| Themen: |
Allogeneic hematopoietic stem cell transplantation |
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| Anmerkungen: |
Date Completed 09.01.2024 Date Revised 09.01.2024 published: Print Citation Status MEDLINE |
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| doi: |
10.3760/cma.j.issn.0253-2727.2023.11.002 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM366761382 |
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| 245 | 1 | 0 | |a Impact of SARS-CoV-2 infection on graft composition and early transplant outcomes following allogeneic hematopoietic stem cell transplantation |
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| 500 | |a Date Revised 09.01.2024 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Objective: To assess the feasibility of using donors with novel coronavirus disease 2019 (COVID-19) for allogeneic hematopoietic stem cell transplantation (allo-HSCT) when there are no other available donors and allo-HSCT cannot be delayed or discontinued. Methods: Seventy-one patients with malignant hematological diseases undergoing allo-HSCT between December 8, 2022, and January 10, 2023, were included. Of these, 16 received grafts from donors with mild COVID-19 (D-COVID(+) group) and 55 received grafts from donors without COVID-19 (D-COVID(-) group). The graft compositions were compared between the two groups. Engraftment, acute graft-versus-host disease (aGVHD), overall survival (OS), and relapse were also evaluated. Results: There were no serious side effects or adverse events in the D-COVID(+) group. The mononuclear cell dose and CD34(+) cell dose were comparable between the two groups, and no additional apheresis was required. There were no significant differences in the lymphocyte, monocyte, and T-cell subset doses between the two groups. The median natural killer cell dose in the D-COVID(+) group was significantly higher than that in the D-COVID(-) group (0.69×10(8)/kg vs. 0.53×10(8)/kg, P=0.031). The median follow-up time was 72 (33-104) days. All patients achieved primary engraftment. The 60-day platelet engraftment rates in the D-COVID(+) and D-COVID(-) groups were 100% and (96.4±0.2) %, respectively (P=0.568). There were no significant differences in neutrophil (P=0.309) and platelet (P=0.544) engraftment times. The cumulative incidence of grade 2-4 aGVHD was (37.5±1.6) % vs. (16.4±0.3) % (P=0.062), and of grade 3-4 aGVHD was 25.0% ±1.3% vs. 9.1% ±0.2% (P=0.095) in the D-COVID(+) and D-COVID(-) groups, respectively. The probabilities of 60-day OS were 100% and 98.1% ±1.8% (P=0.522) in the D-COVID(+) and D-COVID(-) groups, respectively. There was no relapse of primary disease during the study period. Conclusion: When allo-HSCT cannot be delayed or discontinued and no other donor is available, a donor with mild COVID-19 should be considered if tolerable. Larger sample sizes and longer follow-up periods are required to validate these results | ||
| 650 | 4 | |a English Abstract | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Allogeneic hematopoietic stem cell transplantation | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Donor | |
| 650 | 4 | |a Malignant hematological disease | |
| 700 | 1 | |a Sun, H |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Y |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Y Y |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, J |e verfasserin |4 aut | |
| 700 | 1 | |a He, Y |e verfasserin |4 aut | |
| 700 | 1 | |a Zheng, F M |e verfasserin |4 aut | |
| 700 | 1 | |a Xu, Z L |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, F R |e verfasserin |4 aut | |
| 700 | 1 | |a Kong, J |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Z D |e verfasserin |4 aut | |
| 700 | 1 | |a Wan, Y Y |e verfasserin |4 aut | |
| 700 | 1 | |a Mo, X D |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Y |e verfasserin |4 aut | |
| 700 | 1 | |a Cheng, Y F |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, X H |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, X J |e verfasserin |4 aut | |
| 700 | 1 | |a Xu, L P |e verfasserin |4 aut | |
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