1
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Bhatt NS, Meyer CL, Mau LW, Auletta JJ, Baker KS, Broglie L, Carpenter PA, Choi SW, Dandoy CE, Devine S, Phelan R. Return to school practices after hematopoietic cell transplantation: a survey of transplant centers in the United States. Bone Marrow Transplant 2024; 59:653-659. [PMID: 38378916 DOI: 10.1038/s41409-024-02239-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/22/2024]
Abstract
To understand transplant center recommendations on return-to-school timing and related support for hematopoietic cell transplant (HCT) survivors, we conducted a two-phase, cross-sectional, web-based survey: In Phase I, medical directors of pediatric HCT centers from the National Marrow Donor Program/ Be The Match Registry were asked regarding the availability of a return to school standardized operating procedure (SOP). In Phase II, HCT physician members of the Pediatric Transplantation and Cellular Therapy Consortium were approached to study inter-physician practice variability regarding return to school post-HCT, factors affecting their decision-making, and support provided by HCT centers for return to school. Out of 46 respondents in Phase I (55% response rate), 28 (61%) reported having a SOP. Wide variations in recommendations were noted in 12 received SOPs. In Phase II, 122 physicians (60 centers) responded (30.6% response rate). The majority (60%) recommended autologous HCT recipients return to school within 6 months post-HCT but 65% recommended allogeneic HCT recipients return to school after 6 months or once off immunosuppression. Our findings indicate a lack of consensus within and across HCT centers regarding recommended return to school timing and underscore need for a guideline to standardize this process to ensure patient safety and re-integration into school.
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Affiliation(s)
- Neel S Bhatt
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.
| | - Christa L Meyer
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN, USA
| | - Lih-Wen Mau
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN, USA
- Tamkang University, Taipei, Taiwan
| | - Jeffery J Auletta
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN, USA
| | - K Scott Baker
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Larisa Broglie
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
- Center for International Blood and Marrow Transplant Research, Milwaukee, WI, USA
| | - Paul A Carpenter
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Sung Won Choi
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MN, USA
| | - Christopher E Dandoy
- Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, OH, USA
| | - Steven Devine
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN, USA
| | - Rachel Phelan
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
- Center for International Blood and Marrow Transplant Research, Milwaukee, WI, USA
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2
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Kamal M, Baudo M, Joseph J, Geng Y, Mohamed O, Rahouma M, Greenbaum U. Characteristics and Outcomes of Stem Cell Transplant Patients during the COVID-19 Era: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2024; 12:530. [PMID: 38470640 PMCID: PMC10931059 DOI: 10.3390/healthcare12050530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/14/2024] [Accepted: 02/17/2024] [Indexed: 03/14/2024] Open
Abstract
This systematic review and meta-analysis aims to identify the outcomes of stem cell transplant (SCT) patients during the COVID-19 era. Pooled event rates (PER) were calculated, and meta-regression was performed. A random effects model was utilized. In total, 36 eligible studies were included out of 290. The PER of COVID-19-related deaths and COVID-19-related hospital admissions were 21.1% and 55.2%, respectively. The PER of the use of hydroxychloroquine was 53.27%, of the receipt of immunosuppression it was 39.4%, and of the use of antivirals, antibiotics, and steroids it was 71.61%, 37.94%, and 18.46%, respectively. The PER of the time elapsed until COVID-19 infection after SCT of more than 6 months was 85.3%. The PER of fever, respiratory symptoms, and gastrointestinal symptoms were 70.9, 76.1, and 19.3%, respectively. The PER of acute and chronic GvHD were 40.2% and 60.9%, respectively. SCT patients are at a higher risk of severe COVID-19 infection and mortality. The use of dexamethasone improves the survival of hospitalized SCT patients with moderate to severe COVID-19 requiring supplemental oxygen or ventilation. The SCT patient group is a heterogeneous group with varying characteristics. The quality of reporting on these patients when infected with COVID-19 is not uniform and further prospective or registry studies are needed to better guide clinical care in this unique setting.
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Affiliation(s)
- Mona Kamal
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Massimo Baudo
- Department of Cardiac Surgery, Spedali Civili di Brescia, 25123 Brescia, Italy;
| | - Jacinth Joseph
- Hematology and Medical Oncology, University of Pittsburg Medical Center-Hillman Cancer Center, Altoona, PA 16601, USA
| | - Yimin Geng
- Research Medical Library, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Omnia Mohamed
- Department of Medical Oncology, NCI, Cairo 11796, Egypt;
| | - Mohamed Rahouma
- Surgical Oncology Department, National Cancer Institute, Cairo 12613, Egypt;
- Cardiothoracic Surgery Department, Weill Cornell Medicine, New York, NY 10065, USA
| | - Uri Greenbaum
- Department of Hematology, Soroka University Medical Center, Beer Sheva 8410501, Israel;
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 8410501, Israel
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Röhsig LM, Nardi NB. Impact of COVID-19 pandemic on cord blood banking and transplantation. Cell Tissue Bank 2024:10.1007/s10561-023-10122-z. [PMID: 38168846 DOI: 10.1007/s10561-023-10122-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 12/07/2023] [Indexed: 01/05/2024]
Abstract
Umbilical cord blood is a rich source of hematopoietic stem cells that has been used for transplantation for over 30 years, especially when there is no compatible hematopoietic stem cell donor available. Its use has decreased more recently, since the development of methods to improve haploidentical transplants has allowed the use of mobilized peripheral blood as a source of hematopoietic stem cells. Public cord blood banks collect, process and store cord blood samples from voluntary donations. In addition, many public banks are involved in research to enhance hematopoietic stem cell therapies and develop new treatments for haematological and genetic diseases. The COVID-19 pandemic, which emerged in 2019, has had a profound and wide-ranging impact on human health and treatment. The area of hematopoietic stem cell transplantation was deeply affected by reductions in bone marrow, peripheral blood and cord blood donations; logistical challenges; exposure of healthcare workers and other challenges. The present study reviews the impact of the COVID-19 pandemic on cord blood banking and transportation around the world with a special focus on Brazil.
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Affiliation(s)
- Liane Marise Röhsig
- Institute of Cardiology of Rio Grande do Sul/University Foundation of Cardiology (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil
- Unit of Cellular Processing Center, Hemotherapy Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Nance Beyer Nardi
- Institute of Cardiology of Rio Grande do Sul/University Foundation of Cardiology (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil.
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Cannici C, Liptrott SJ, Serra N, Samarani E, De Cecco V, Caime A, Galgano L, Rostagno E, Orlando L, Gargiulo G, Cioce M, Lupo R, Capuano A, Rea T, Botti S. Predictive factors of sleep quality and burnout in nurses working in transplant units during the COVID-19 lockdown - A cross-sectional study. Contemp Nurse 2023; 59:362-376. [PMID: 37550812 DOI: 10.1080/10376178.2023.2244090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 07/26/2023] [Indexed: 08/09/2023]
Abstract
Background: There is minimal information regarding sleep disturbance and burnout during COVID-19 in nurses working within haematology-oncology and hematopoietic stem cell transplantation (HSCT) settings.Aim: To identify socio-demographic and professional factors that predicted burnout and sleep disturbance during COVID-19 in nurses working in HSCT settings.Design/Methods: Data were collected using the Maslach Burnout Inventory and the Pittsburgh Sleep Quality Index. Descriptive statistics and linear regression examined relationships.Results: 308 responses were received. Nurses working in outpatient settings had greater emotional exhaustion (Rpartial = -0.12, n = 308, p = 0.03). Negative predictors for quality of sleep were transplant programme setting (Rpartial = -0.19, n = 308, p < 0.01) and years working in HSCT (Rpartial = -0.17, n = 308, p < 0.01). Other relationships were found on univariate analysis.Conclusion: Institutions must offer programmes for nurses to develop sleep strategies, self-care, and work-related stress management.
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Affiliation(s)
- Chiara Cannici
- Division of Hematology, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, via Venezia 16, Alessandria, 15121, Italy
| | - Sarah Jayne Liptrott
- Istituto Oncologico della Svizzera Italiana, EOC, via A. Gallino 12, 6500, Bellinzona, Switzerland
- Ospedale Regionale di Bellinzona e Valli, EOC, via A. Gallino 12, 6500 Bellinzona, Switzerland
| | - Nicola Serra
- Department of Public Health, University Federico II of Naples, via S. Pansini 5, 80131 Naples, Italy
| | - Emanuela Samarani
- Unit of Blood Diseases and Stem Cell Transplantation, ASST Spedali Civili, Piazzale Spedali Civili 1, 25100 Brescia, Italy
| | - Valentina De Cecco
- Department of Onco-Haematology and Cell and Gene Therapy, Bambino Gesù Children's Hospital IRCCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy
| | - Alessandro Caime
- Division of Hemato-Oncology, European Institute of Oncology IRCCS, via Ripamonti 435, 20141 Milan, Italy
| | - Letizia Galgano
- SOD Transfusion Medicine and Cell Therapies, AOU-Careggi, Largo Brambilla 3, 50139 Firenze, Italy
| | - Elena Rostagno
- SSD Oncoematologia Pediatrica, IRCCS Azienda Ospedaliero Universitaria di Bologna, via Giuseppe Massarenti 13, 40138 Bologna, Italy
| | - Laura Orlando
- Istituto Oncologico della Svizzera Italiana, EOC, via A. Gallino 12, 6500, Bellinzona, Switzerland
| | - Gianpaolo Gargiulo
- Haematology Unit, Federico II University Hospital of Naples, via S. Pansini 5, 80131 Naples, Italy
| | - Marco Cioce
- Hematology and Trasplant Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Roberto Lupo
- Emergency Unit, ASL Lecce "San Giuseppe da Copertino" Hospital, via Carmiano 1, 73043 Copertino Lecce, Italy
| | - Angela Capuano
- Department of Emergency, AORN Santobono-Pausilipon, via T. Ravaschieri n. 8, 80122 Naples, Italy
| | - Teresa Rea
- Department of Public Health, University Federico II of Naples, via S. Pansini 5, 80131 Naples, Italy
| | - Stefano Botti
- Hematology Unit, Azienda USL-IRCCS di Reggio Emilia, viale Risorgimento 80, 42123 Reggio Emilia, Italy
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5
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Isaia G, Valerio S, Oliva S, Brunetti E, Bo M. Atypical Course of SarsCov-2 Infection in a Patient with Multiple Myeloma Treated with Autologous Stem Cell Transplantation. Int J Hematol Oncol Stem Cell Res 2023; 17:128-131. [PMID: 37637765 PMCID: PMC10452944 DOI: 10.18502/ijhoscr.v17i2.12652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 01/15/2022] [Indexed: 08/29/2023] Open
Abstract
Covid-19 infection has more relevant consequences in frail and comorbid patients, but little is known about its course in patients with hematologic malignancies. In this report, we would like to present the case of a patient with multiple myeloma treated with recent autologous bone marrow stem cell transplantation and affected by Covid-19 pneumonia, presenting with a possible reinfection or an extremely long viral shedding.
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Affiliation(s)
- Gianluca Isaia
- Section of Geriatrics, Department of Medical Sciences, Università degli Studi di Torino, A.O.U. Città della Salute e della Scienza di Torino, Molinette, Corso Bramante 88, 10126, Turin, Italy
| | - Silvia Valerio
- Section of Geriatrics, Department of Medical Sciences, Università degli Studi di Torino, A.O.U. Città della Salute e della Scienza di Torino, Molinette, Corso Bramante 88, 10126, Turin, Italy
| | - Stefania Oliva
- Department of Oncology, Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Enrico Brunetti
- Section of Geriatrics, Department of Medical Sciences, Università degli Studi di Torino, A.O.U. Città della Salute e della Scienza di Torino, Molinette, Corso Bramante 88, 10126, Turin, Italy
| | - Mario Bo
- Section of Geriatrics, Department of Medical Sciences, Università degli Studi di Torino, A.O.U. Città della Salute e della Scienza di Torino, Molinette, Corso Bramante 88, 10126, Turin, Italy
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6
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Kaviani M, Azarpira N. Severe Acute Respiratory Syndrome Coronavirus Type 2: Insight Into Challenges for Cell Therapy. EXP CLIN TRANSPLANT 2023; 21:12-15. [PMID: 33622218 DOI: 10.6002/ect.2020.0239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Coronavirus disease 2019 has affected more than 4 million people throughout the world since December 2019. It seems this infection has been the most insidious virus of the coronavirus family. This virus causes severe respiratory failure and symptoms in patients and can result in death. Designing a restrict protocol to deal with infections from severe acute respiratory syndrome coronavirus type 2 is critical in cell therapy institutes. In this review, we present the important aspects related to this virus in cell therapy protocols.
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Affiliation(s)
- Maryam Kaviani
- From the Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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7
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Ali G, Altareb M, Chaudhri N, Alfraih F. Outcome of Haploidentical Hematopoietic Stem Cell Transplantation with a Donor and Recipient Infected with SARS-CoV-2 Infection. J Appl Hematol 2023. [DOI: 10.4103/joah.joah_10_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
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8
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Koo J, Auletta JJ, Hartley DM, Huber J, Jaglowski S, Kapadia M, Kusnier K, Lehmann L, Maakaron J, Myers KC, Pai A, Parker L, Phelan R, Sper C, Rotz SJ, Dandoy CE. Secondary Impact of the Coronavirus Disease 19 Pandemic on Patients and the Cellular Therapy Healthcare Ecosystem. Transplant Cell Ther 2022; 28:737-746. [PMID: 35902050 PMCID: PMC9313529 DOI: 10.1016/j.jtct.2022.07.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 11/24/2022]
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has significantly impacted global health and healthcare delivery systems. To characterize the secondary effects of the COVID-19 pandemic and mitigation strategies used in the delivery of hematopoietic stem cell transplantation (HSCT) care, we performed a comprehensive literature search encompassing changes in specific donor collection, processing practices, patient outcomes, and patient-related concerns specific to HSCT and HSCT-related healthcare delivery. In this review, we summarize the available literature on the secondary impacts the COVID-19 pandemic on the fields of HSCT and cellular therapy. The COVID-19 pandemic has had numerous secondary impacts on patients undergoing HSCT and the healthcare delivery systems involved in providing complex care to HSCT recipients. Institutions must identify these influences on outcomes and adjust accordingly to maintain and improve outcomes for the transplantation and cellular therapy community.
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Affiliation(s)
- Jane Koo
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio.
| | - Jeffrey J Auletta
- Center for International Blood and Marrow Transplant Research, Milwaukee, Wisconsin; Hematology/Oncology/BMT and Infectious Diseases, Nationwide Children's Hospital, Columbus, Ohio
| | - David M Hartley
- Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio; James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - John Huber
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio
| | - Samantha Jaglowski
- Division of Hematology-Oncology and Transplantation; Department of Pediatrics, Ohio State University Medical Center, Columbus, Ohio
| | - Malika Kapadia
- Division of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Department of Pediatrics, Harvard University Medical School, Boston, Massachusetts
| | - Katilyn Kusnier
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio
| | - Leslie Lehmann
- Division of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Department of Pediatrics, Harvard University Medical School, Boston, Massachusetts
| | - Joseph Maakaron
- Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Kasiani C Myers
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio
| | - Ahna Pai
- Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio; Department of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Loretta Parker
- Division of Hematology/Oncology, Department of Pediatrics, The University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
| | - Rachel Phelan
- Division of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Department of Pediatrics, Medical College of Wisconsin and Children's Wisconsin, Milwaukee, Wisconsin
| | - Christine Sper
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Seth J Rotz
- Department of Pediatric Hematology, Oncology, and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio
| | - Christopher E Dandoy
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio
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9
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Kenis I, Theys S, Hermie E, Foulon V, Van Hecke A. Impact of COVID-19 on the Organization of Cancer Care in Belgium: Lessons Learned for the (Post-)Pandemic Future. Int J Environ Res Public Health 2022; 19:12456. [PMID: 36231756 PMCID: PMC9566094 DOI: 10.3390/ijerph191912456] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/21/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic has posed tremendous challenges to healthcare systems. Care for oncology patients, a vulnerable population during the pandemic, was disrupted and drastically changed. A multicenter qualitative study was conducted in 11 Belgian hospitals with the aim to provide an overview of the most important changes that were made in the care of oncology patients in Belgium. In each hospital, a nurse or physician was interviewed by telephone. Two rounds of structured interviews-during the first and second waves of the pandemic-were conducted. The data were analyzed using content analysis. The impact of COVID-19 on care practices for patients with cancer was enormous during the first wave. Major changes, including good but also less patient-centered practices, were implemented with unprecedented speed. After the initial wave, regular care was resumed and only limited new care practices were maintained. In only a few hospitals, healthcare teams reflected on lessons learned and on the maintenance of good practices that came from the COVID-19 experience. As a result, opportunities for healthcare innovation and quality improvement seemed to be missed. Our recommendations aim to support policymakers, hospital managers, and healthcare professionals to learn from the COVID-19 pandemic and to drive patient-centered initiatives in future cancer care.
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Affiliation(s)
- Ilyse Kenis
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Sofie Theys
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Ella Hermie
- Science in Nursing and Midwifery, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium
| | - Veerle Foulon
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium
| | - Ann Van Hecke
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
- Nursing Department, Ghent University Hospital, 9000 Ghent, Belgium
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10
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Rafii H, Ionescu I, Ruggeri A, Garnier F, Ballot C, Bensoussan D, Chabannon C, Dazey B, De Vos J, Gautier E, Giraud C, Larghero J, Cras A, Mialou V, Persoons V, Pouthier F, Thibert JB, Dalle JH, Michel G, Sinayoko M, Kenzey C, Volt F, Rocha V, Bay JO, Rubio MT, Robin M, Faucher C, Marry E, Gluckman E. Impact of COVID-19 pandemic on the use and release of cord blood units facilitated by the French Cord Blood Banks Network: on behalf of the Agency of Biomedicine, Eurocord and the French Society of Bone Marrow Transplant and Cell Therapy (SFGM-TC). Bone Marrow Transplant 2022; 57:125-7. [PMID: 34621021 DOI: 10.1038/s41409-021-01477-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 09/05/2021] [Accepted: 09/21/2021] [Indexed: 02/08/2023]
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11
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Geng Y, Zhang L. The impact of non-pharmaceutical interventions during COVID-19 pandemic on three children infectious diseases in China. J Infect 2021:S0163-4453(21)00645-9. [PMID: 34953908 DOI: 10.1016/j.jinf.2021.12.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 12/19/2021] [Indexed: 12/28/2022]
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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.
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Affiliation(s)
- Marcie Riches
- Division of Hematology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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13
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Qatawneh M, Aljazazi M, Altarawneh M, Aljamaen H, Mustafa M, Alqasem A, Sharar AA. Hematopoietic Stem Cell Transplantation During the Era of COVID-19 in Queen Rania Children's Hospital. Mater Sociomed 2021; 33:131-137. [PMID: 34483742 PMCID: PMC8385744 DOI: 10.5455/msm.2021.33.131-137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 06/20/2021] [Indexed: 01/08/2023] Open
Abstract
Background: Corona virus disease 2019 (COVID-19) is causing a health crisis nowadays, and all countries are following the recommendations of the WHO to decrease the spread of the disease. Till now, few data are available regarding the clinical course, severity of the disease and the duration of infectivity of COVID-19 in patients received Hematopoietic Stem Cell Transplantation (HSCT). Objective: To evaluate the medical protocols and outcome of patients who underwent HSCT during the pandemic of COVID-19. Methods: A retrospective review of the medical files of patients who underwent hematopoietic stem cell transplantation during the era of COVID-19. The following data were reviewed for all patients: age, gender, primary disease, viral screening protocols for donors and recipients, COVID-19 status and outcome. The European society for blood and marrow transplantation (EBMT) guidelines were applied strictly on all of our patients, donors and bone marrow transplant unit staff. Results: A total of 10 children were transplanted, 8 of them received allogenic transplant from matched donor and two patients received autologous transplant. Regarding allogenic transplants, all of our patients except two were transplanted as an emergency, 2 of them were Aplastic anemia, 2 patients were Fanconi anemia, one patient was Amegakaryocytic thrombocytopenia, and one patient was Acute myeloid leukemia. Only two patients were not an emergency as one of them had Thalassemia major and the other one was Sickle cell anemia. The autologous transplant was done for two patients with Neuroblastoma stage 4 as part of their treatment protocol. At a median follow up of 5.5 months (range, 2 month-7 months) two patients (20%) developed COVID-19, which was asymptomatic in both of them. One of our patients (10%) died due to cytomegalovirus (CMV) pneumonia. No one of our patient was affected by the emergency regulations applied by the country and hospitals during the pandemic of COVID-19 virus. Conclusion: Hematopoietic stem cell transplantation can be performed safely for emergency cases, if we strictly follow the guidelines of EBMT.
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Affiliation(s)
- Mousa Qatawneh
- Department of Pediatric Hematology and Medical Oncology, Queen Rania Children's Hospital. Queen Rania AL- Abdullah children Hospital (QRCH), Jordan
| | - Mais Aljazazi
- Department of Pediatric Hematology and Medical Oncology, Queen Rania Children's Hospital. Queen Rania AL- Abdullah children Hospital (QRCH), Jordan
| | - Moath Altarawneh
- Department of Pediatric Hematology and Medical Oncology, Queen Rania Children's Hospital. Queen Rania AL- Abdullah children Hospital (QRCH), Jordan
| | | | - Maher Mustafa
- Department of Pediatric Hematology and Medical Oncology, Queen Rania Children's Hospital. Queen Rania AL- Abdullah children Hospital (QRCH), Jordan
| | - Alaa Alqasem
- Department of Pediatric Hematology and Medical Oncology, Queen Rania Children's Hospital. Queen Rania AL- Abdullah children Hospital (QRCH), Jordan
| | - Amjad Abu Sharar
- Department of Pediatric Hematology and Medical Oncology, Queen Rania Children's Hospital. Queen Rania AL- Abdullah children Hospital (QRCH), Jordan
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14
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El Cheikh J, El Warrak S, Ghaoui N, Al Chami F, Shahbaz M, Chehayeb S, Saghir N, Bazarbachi A, Taher A. Implemented Interventions at the Naef K. Basile Cancer Institute to Protect Patients and Medical Personnel From COVID Infections: Effectiveness and Patient Satisfaction. Front Oncol 2021; 11:685107. [PMID: 34195088 PMCID: PMC8237752 DOI: 10.3389/fonc.2021.685107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/07/2021] [Indexed: 01/08/2023] Open
Abstract
Background The Coronavirus Disease 2019 (COVID-19) was declared a pandemic by WHO in March 2020. The first case of COVID-19 was identified in Lebanon on the 21st of February 2020, amid a national economic crisis. As the numbers of cases increased, ICU admissions and mortality rose, which led hospitals across Lebanon to take certain safety measures to contain the virus. The Naef K. Basile Cancer Institute (NKBCI) at the American University of Beirut Medical Center handles oncology outpatient visits and outpatient treatment protocol infusions. The aim of this study is to evaluate the efficacy of the safety measures put forth by the NKBCI early in the pandemic. Methods Oncology patients are amongst the immunosuppressed population, who are at greatest risk of contracting COVID-19 and consequently suffering its complications. In this manuscript, we evaluated the precautionary measures implemented at the NKBCI of AUBMC from March 1st to May 31st of 2020, by surveying oncology patients on the telephone who had live and virtual appointments in both the oncology outpatient clinics and infusion unit. We conducted a prospective study of 670 oncology patients who had appointments at the NKBCI during this period and used their answers to draw responses about patient satisfaction towards those safety measures. Results Our results involved 387 responses of oncology patients who visited the NKBCI during the period of March 1st to May 31st of 2020. 99% of our respondents gave a rating of good to excellent with these new measures. The option of online consultation was given to 35% in the hematology group compared to 19% in those with solid tumors (p=0.001). From the total, 15% of patients opted for the telemedicine experience as a new implemented strategy to provide patient-centered medical care. Of this group of patients, 22% faced problems with connectivity and 19% faced problems with online payment. Conclusion NKBCI was competent in following the WHO guidelines in protecting the oncology patient population. Feedback collected from the surveys will be taken into account by the committee of the NKBCI to develop new safety measures that can better control viral spread while providing patient-centered medical care.
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Affiliation(s)
- Jean El Cheikh
- Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Samantha El Warrak
- Cancer Research Institute, Department of Internal medicine, Hematology/Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nohra Ghaoui
- Cancer Research Institute, Department of Internal medicine, Hematology/Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon
| | - Farouk Al Chami
- Cancer Research Institute, Department of Internal medicine, Hematology/Oncology Division, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maya Shahbaz
- Faculty of Sciences, Lebanese University, Beirut, Lebanon
| | - Sarah Chehayeb
- Department of Nursing, Naef. K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nagi Saghir
- Division of Hematology/Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ali Bazarbachi
- Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ali Taher
- Division of Hematology/Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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15
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Barhoom D, Mohseni R, Hamidieh AA, Mohammadpour M, Sharifzadeh M, Navaeian A, Taebi S, Behfar M. Clinical Effects of COVID-19 on Hematopoietic Stem Cell Transplant Outcomes in Pediatric Patients. EXP CLIN TRANSPLANT 2021; 19:501-507. [PMID: 34053422 DOI: 10.6002/ect.2020.0518] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Coronavirus disease 2019 is the third zoonotic acute respiratory disease after SARS virus and Middle East respiratory syndrome. Most cases are mild in healthy children. In contrast, the infection is more severe in patients with underlying health conditions. Because there are few posttransplant reports in hematopoietic stem celltransplant patients, here we described COVID19 infection in 4 confirmed cases among pediatric hematopoietic stem cell transplant recipients: 3 boys and 1 girl with a median age of 6 years. Three patients presented with symptoms of lower respiratory tract disease, whereas 1 patient presented with extrapulmonary symptoms without fever or pulmonary involvement. All of the patients were on immunosuppressivedrugs, ie, 1patientforgraft-versus-hostdisease prophylaxis and 3 patients for graft-versus-host disease treatment.Thosewhowerediagnosedwith active graftversus-hostdisease requiredmechanical ventilationand intensive care. Two patients died from multiple organ dysfunction and resistant coinfection, and 1 patient developed pulmonary hypertension and mild cardiomegaly and remained at the hospital for more than 2 months, whereas the patient with no graft-versus-host disease was discharged and recovered. Our findings showed that COVID-19 infection among hematopoietic stem cell transplant recipients may be more severe and associatedwithlong-termhospitalization and complications. Active graft-versus-hostdisease, coinfections, and long-term use of immunosuppressive agents are risk factors for poor outcomes.
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Affiliation(s)
- Dima Barhoom
- From the Pediatric Cell and Gene Therapy Research Center, Tehran University of Medical Sciences, Tehran, Iran; and the Pediatric Hematopoietic Stem Cell Transplant Department, Children's Hospital, Damascus University, Damascus, Syria
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16
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Abstract
Currently, coronavirus disease 2019 (COVID-19) has spread worldwide and continues to rise. There remains a significant unmet need for patients with hematological malignancies requiring specialized procedures and treatments, like cellular therapy to treat or cure their disease. For instance, chimeric antigen receptor T (CAR-T) cell therapy is approved for relapsed/refractory (after two or more lines of therapy) diffuse large B cell lymphoma and B cell acute lymphoblastic leukemia that is refractory or in the second relapse in patients younger than 25 years of age. Similarly, hematopoietic stem cell transplantation (HSCT) can be a lifesaving procedure for many patients, such as those with acute myeloid leukemia with high-risk cytogenetics. Unfortunately, the COVID-19 pandemic has thrust upon the hematologists and transplant specialists' unique challenges with the implementation and management of cellular therapy. One of the significant concerns regarding this immunocompromised patient population is the significant risk of acquiring SARS-CoV-2 infection due to its highly contagious nature. Experts have recommended that if medically indicated, especially in high-risk disease (where chemotherapy is unlikely to work), these lifesaving procedures should not be delayed even during the COVID-19 pandemic. However, proceeding with CAR-T cell therapy and HSCT during the pandemic is a considerable task and requires dedication from the transplant team and buy-in from the patients and their family or support system. Open conversations should be held with the patients about the risks involved in undergoing cellular therapies during current times and the associated future uncertainties.
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17
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Wiercinska E, Schlipfenbacher V, Bug G, Bader P, Verbeek M, Seifried E, Bonig H. Allogeneic transplant procurement in the times of COVID-19: Quality report from the central European cryopreservation site. J Transl Med 2021; 19:145. [PMID: 33832504 DOI: 10.1186/s12967-021-02810-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/28/2021] [Indexed: 01/14/2023] Open
Abstract
Background Because of limitations of transportation imposed by the COVID-19 pandemic, current recommendation calls for cryopreservation of allogeneic stem cell transplants before patient conditioning. A single cell therapy laboratory was selected to function as the central cryopreservation hub for all European registry donor transplants intended for the Australian-Pacific region. We examined properties of these transplants to ascertain how quality is maintained. Methods We analyzed 100 pandemic-related allogeneic mobilized blood-derived stem cell apheresis products generated at 30 collection sites throughout Europe, shipped to and cryopreserved at our center between April and November of 2020. Products were shipped in the cool, subsequently frozen with DMSO as cryoprotectant. Irrespective of origin, all products were frozen within the prescribed shelf-life of 72 h. Results Prior to cryopreservation, viable stem cell and leukocyte count according to the collection site and our reference laboratory were highly concordant (r2 = 0.96 and 0.93, respectively) and viability was > 90% in all instances. Median nominal post-thaw recovery of viable CD34+ cells was 42%. Weakly associated with poorer CD34+ cell recovery was higher leukocyte concentration, but not time lag between apheresis or addition of cryopreservant, respectively, and start of freezing. The correlation between pre- and post-thaw CD34+ cell dose was high (r2 = 0.85), hence predictable. Neutrophil and platelet engraftment were prompt with no evidence of dose dependency within the range of administered cell doses (1.31–15.56 × 106 CD34+ cells/kg). Conclusions General cryopreservation of allogeneic stem cell transplants is feasible. While more than half of the CD34+ cell content is lost, the remaining stem cells ensure timely engraftment. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-021-02810-9.
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18
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Ramírez-López A, Lázaro Del Campo P, Humala K, De la Cruz Benito B, Sánchez-Vadillo I, López de la Guía A, de Paz Arias R, Jiménez-Yuste V, Canales M. Lessons learned for successful treatment of AML in the second wave of COVID-19 outbreak. Leuk Lymphoma 2021; 62:2034-2036. [PMID: 33645389 DOI: 10.1080/10428194.2021.1886291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- A Ramírez-López
- Hematology Department, Hospital Universitario La Paz, Madrid, Spain
| | | | - K Humala
- Hematology Department, Hospital Universitario La Paz, Madrid, Spain
| | | | | | | | - R de Paz Arias
- Hematology Department, Hospital Universitario La Paz, Madrid, Spain
| | - V Jiménez-Yuste
- Hematology Department, Hospital Universitario La Paz, Madrid, Spain
| | - M Canales
- Hematology Department, Hospital Universitario La Paz, Madrid, Spain
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19
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Maurer K, Saucier A, Kim HT, Acharya U, Mo CC, Porter J, Albert C, Cutler C, Antin JH, Koreth J, Gooptu M, Romee R, Wu CJ, Soiffer RJ, Nikiforow S, Jacobson C, Ho VT. COVID-19 and hematopoietic stem cell transplantation and immune effector cell therapy: a US cancer center experience. Blood Adv 2021; 5:861-871. [PMID: 33560397 PMCID: PMC7869610 DOI: 10.1182/bloodadvances.2020003883] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 01/06/2021] [Indexed: 02/07/2023] Open
Abstract
The novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), identified in late 2019 as the causative agent of COVID-19, was declared a pandemic by the World Health Organization on 11 March 2020. Widespread community transmission in the United States triggered a nationwide shutdown, raising major challenges for administration of hematopoietic stem cell transplant (HSCT) and chimeric antigen receptor (CAR)-T cell therapies, leading many centers to delay or cancel operations. We sought to assess the impact of the COVID-19 pandemic on operations and clinical outcomes for HSCT and CAR-T cellular therapies at the Dana-Farber Cancer Institute by reviewing administration and outcomes in 127 cell therapy patients treated during the initial COVID-19 surge: 62 adult allogeneic HSCT (allo-HSCT), 38 autologous HSCT (auto-HSCT), and 27 CAR-T patients. Outcomes were compared with 66 allo-HSCT, 43 auto-HSCT, and 33 CAR-T patients treated prior to the pandemic. A second control cohort was evaluated for HSCT groups to reflect seasonal variation in infections. Although there were changes in donor selection and screening as well as cryopreservation patterns of donor products, no differences were observed across groups in 100-day overall survival, progression-free survival, rates of non-COVID-19 infections, including hospital length of stay, neutrophil engraftment, graft failure, acute graft-versus-host disease in allo-HSCT patients, or cytokine release syndrome and neurotoxicity in CAR-T patients. No HSCT patients contracted COVID-19 between days 0 and 100. One CAR-T patient contracted COVID-19 at day +51 and died of the disease. Altogether, our data indicate that cellular therapies can be safely administered throughout the ongoing COVID-19 pandemic with appropriate safeguards.
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Affiliation(s)
- Katie Maurer
- Division of Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Anna Saucier
- Division of Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Haesook T Kim
- Department of Data Science, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; and
| | - Utkarsh Acharya
- Division of Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Clifton C Mo
- Division of Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Julie Porter
- Department of Cellular Therapies Quality Assurance and
| | - Cindy Albert
- Stem Cell Transplant Donor Services, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Corey Cutler
- Division of Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Joseph H Antin
- Division of Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - John Koreth
- Division of Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Mahasweta Gooptu
- Division of Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Rizwan Romee
- Division of Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Catherine J Wu
- Division of Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Robert J Soiffer
- Division of Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Sarah Nikiforow
- Division of Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Caron Jacobson
- Division of Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Vincent T Ho
- Division of Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
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20
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Russo D, Polverelli N, Malagola M, Farina M, Leoni A, Bernardi S, Mammoliti S, Sacchi N, Martino M, Ciceri F. Changes in Stem Cell Transplant activity and procedures during SARS-CoV2 pandemic in Italy: an Italian Bone Marrow Transplant Group (GITMO) nationwide analysis (TransCOVID-19 Survey). Bone Marrow Transplant 2021; 56:2272-2275. [PMID: 33875810 PMCID: PMC8054130 DOI: 10.1038/s41409-021-01287-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 03/09/2021] [Accepted: 03/25/2021] [Indexed: 02/05/2023]
Abstract
The Transplant Centers belonging to Gruppo Italiano per il Trapianto di Midollo Osseo (GITMO) conducted a survey with the aim of evaluating the effect of SARS-CoV2 pandemic on the allogeneic transplant activity in Italy. The pandemic period from 1/3/2020 to 31/7/2020 was compared with the same period in 2019. Overall, in 2020 there was a 2.4% reduction in the number of allo-HCT cases compared to 2019. Interestingly, this deflection did not affect the acute leukemia cases (+5.7% in 2020). The use of peripheral blood-derived stem cells (+10.7%) and cryopreservation (97.4% of the centers) was highly adopted in 2020. Despite the sanitary emergency, almost all of the surveyed centers declared no impact of SARS-CoV2 pandemic on the transplant timing and outcomes, and the sanitary policy was positively evaluated by the majority of centers. The emergency measures ensured that only a minority of the allo-HCT patients had been infected by SARS-CoV2; however, a mortality of 42.1% among the allo-HCT patients hospitalized for COVID-19 was recorded. This survey gives us the information that the GITMO Group reacted positively to the pandemic. Thanks to the emergency strategies, the Italian allo-HCT activity continued safely, showing only a minor deflection and offering the same probability of cure to the transplanted patients.
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Affiliation(s)
- Domenico Russo
- grid.7637.50000000417571846Unit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Nicola Polverelli
- grid.7637.50000000417571846Unit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Michele Malagola
- grid.7637.50000000417571846Unit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Mirko Farina
- grid.7637.50000000417571846Unit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Alessandro Leoni
- grid.7637.50000000417571846Unit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Simona Bernardi
- grid.7637.50000000417571846Unit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy ,grid.412725.7Centro di Ricerca Emato-Oncologica AIL (CREA), ASST Spedali Civili di Brescia, Brescia, Italy
| | | | - Nicoletta Sacchi
- grid.450697.90000 0004 1757 8650Italian Bone Marrow Donor Registry, Galliera Hospital, Genova, Italy
| | - Massimo Martino
- Stem Cell Transplant Program, Clinical Section, Department of Hemato-Oncology and radiotherapy, Grande Ospedale Metropolitano “Bianchi-Melacrino-Morelli”, Reggio Calabria, Italy
| | - Fabio Ciceri
- grid.18887.3e0000000417581884San Raffaele Scientific Institute, Milan, Italy
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21
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Alicea Marrero MM, Silio M, McQueen‐Amaker K, Español M, Velez M, LeBlanc Z. Posthematopoietic stem cell transplant COVID-19 infection in a pediatric patient with IPEX syndrome. Pediatr Blood Cancer 2021; 68:e28578. [PMID: 32969118 PMCID: PMC7536928 DOI: 10.1002/pbc.28578] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 06/24/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Minelys M. Alicea Marrero
- Pediatric Hematology Oncology DepartmentChildren's Hospital of New OrleansLouisiana State University Health Sciences CenterNew OrleansLouisiana
| | - Margarita Silio
- Pediatric Infectious DiseasesTulane UniversityNew OrleansLouisiana
| | - Katie McQueen‐Amaker
- Pediatric Hematology Oncology DepartmentChildren's Hospital of New OrleansLouisiana State University Health Sciences CenterNew OrleansLouisiana
| | - María Español
- Pediatric Hematology Oncology DepartmentChildren's Hospital of New OrleansLouisiana State University Health Sciences CenterNew OrleansLouisiana
| | - María Velez
- Pediatric Hematology Oncology DepartmentChildren's Hospital of New OrleansLouisiana State University Health Sciences CenterNew OrleansLouisiana
| | - Zachary LeBlanc
- Pediatric Hematology Oncology DepartmentChildren's Hospital of New OrleansLouisiana State University Health Sciences CenterNew OrleansLouisiana
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22
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Greco R, Alexander T, Burman J, Del Papa N, de Vries-Bouwstra J, Farge D, Henes J, Kazmi M, Kirgizov K, Muraro PA, Ricart E, Rovira M, Saccardi R, Sharrack B, Snarski E, Withers B, Jessop H, Boglione C, Kramer E, Badoglio M, Labopin M, Orchard K, Corbacioglu S, Ljungman P, Mikulska M, De la Camara R, Snowden JA. Hematopoietic stem cell transplantation for autoimmune diseases in the time of COVID-19: EBMT guidelines and recommendations. Bone Marrow Transplant 2021; 56:1493-1508. [PMID: 34031556 PMCID: PMC8143059 DOI: 10.1038/s41409-021-01326-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/17/2021] [Accepted: 04/21/2021] [Indexed: 02/07/2023]
Abstract
Coronavirus disease-19 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), represents one of the biggest challenges of 21st century, threatening public health around the globe. Increasing age and presence of co-morbidities are reported risk factors for severe disease and mortality, along with autoimmune diseases (ADs) and immunosuppressive treatments such as haematopoietic stem cell transplantation (HSCT), which are also associated with adverse outcomes. We review the impact of the pandemic on specific groups of patients with neurological, rheumatological, and gastroenterological indications, along with the challenges delivering HSCT in adult and pediatric populations. Moving forward, we developed consensus-based guidelines and recommendations for best practice and quality of patient care in order to support clinicians, scientists, and their multidisciplinary teams, as well as patients and their carers. These guidelines aim to support national and international organizations related to autoimmune diseases and local clinical teams delivering HSCT. Areas of unmet need and future research questions are also highlighted. The waves of the COVID-19 pandemic are predicted to be followed by an "endemic" phase and therefore an ongoing risk within a "new normality". These recommendations reflect currently available evidence, coupled with expert opinion, and will be revised according to necessary modifications in practice.
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Affiliation(s)
- Raffaella Greco
- grid.15496.3fUnit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Tobias Alexander
- grid.7468.d0000 0001 2248 7639Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Joachim Burman
- grid.8993.b0000 0004 1936 9457Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | | | - Jeska de Vries-Bouwstra
- grid.10419.3d0000000089452978Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Dominique Farge
- Centre de Référence des Maladies Auto-Immunes Systémiques Rares d’Ile-de-France, Filière, Paris, France ,grid.508487.60000 0004 7885 7602EA 3518, Université Denis Diderot, Paris, France ,grid.14709.3b0000 0004 1936 8649Department of Internal Medicine, McGill University, Montreal, QC Canada
| | - Jörg Henes
- grid.411544.10000 0001 0196 8249Department for Internal Medicine II (Oncology, Hematology, Rheumatology and Immunology), University Hospital Tuebingen, Tübingen, Germany
| | - Majid Kazmi
- grid.239826.40000 0004 0391 895XKings Health Partners, Department of Haematology, Guys Hospital, London, UK
| | - Kirill Kirgizov
- N.N. Blokhin National Medical Center of Oncology, Institute of Pediatric Oncology and Hematology, Moscow, Russia
| | - Paolo A. Muraro
- grid.7445.20000 0001 2113 8111Department of Brain Sciences, Imperial College London, London, UK
| | - Elena Ricart
- grid.410458.c0000 0000 9635 9413Inflammatory Bowel Disease Unit, Gastroenterology Department, Hospital Clinic of Barcelona, Barcelona, Spain ,grid.10403.36Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
| | - Montserrat Rovira
- grid.10403.36BMT Unit, Department of Haematology, Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Institute Josep Carreras, Barcelona, Spain
| | - Riccardo Saccardi
- grid.24704.350000 0004 1759 9494Department of Haematology, Careggi University Hospital, Florence, Italy
| | - Basil Sharrack
- grid.31410.370000 0000 9422 8284Department of Neuroscience, Sheffield Teaching Hospitals NHS, Foundation Trust, Sheffield, UK ,grid.11835.3e0000 0004 1936 9262NIHR Neurosciences Biomedical Research Centre, University of Sheffield, Sheffield, UK
| | - Emilian Snarski
- grid.13339.3b0000000113287408Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland ,LUX MED Oncology, Warsaw, Poland ,grid.499028.ePolish Stem Cells Bank (PBKM), Warsaw, Poland
| | - Barbara Withers
- Department of Haematology and Bone Marrow Transplant, Sydney, Australia
| | - Helen Jessop
- grid.31410.370000 0000 9422 8284Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Claudia Boglione
- grid.24704.350000 0004 1759 9494Department of Haematology, Careggi University Hospital, Florence, Italy
| | - Ellen Kramer
- Patient Advocacy Committee, EBMT Executive Office, Eddific Dr. Frederic, Duran i Jorda, Barcelona, Spain
| | - Manuela Badoglio
- grid.492743.fEBMT Paris study office/CEREST-TC—Department of Haematology, Saint Antoine Hospital—INSERM UMR 938—Université Pierre et Marie Curie, Paris, France
| | - Myriam Labopin
- grid.492743.fEBMT Paris study office/CEREST-TC—Department of Haematology, Saint Antoine Hospital—INSERM UMR 938—Université Pierre et Marie Curie, Paris, France
| | - Kim Orchard
- grid.123047.30000000103590315Department of Haematology, University Hospital Southampton and University of Southampton, Southampton, UK
| | - Selim Corbacioglu
- grid.7727.50000 0001 2190 5763Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Regensburg, Regensburg, Germany
| | - Per Ljungman
- grid.24381.3c0000 0000 9241 5705Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska University Hospital Huddinge; Division of Hematology, Department of Medicine Huddinge Karolinska Institutet, Stockholm, Sweden
| | - Malgorzata Mikulska
- grid.410345.70000 0004 1756 7871Division of Infectious Diseases, University of Genoa (DISSAL) and Ospedale Policlinico San Martino, Genoa, Italy
| | - Rafael De la Camara
- grid.411251.20000 0004 1767 647XDepartment of Hematology, Hospital de la Princesa, Madrid, Spain
| | - John A. Snowden
- grid.31410.370000 0000 9422 8284Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK ,grid.11835.3e0000 0004 1936 9262Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
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23
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Auletta JJ, Novakovich JL, Stritesky GL, Newman J, Fridy-Chesser ST, Hailperin K, Devine SM. Meeting the Demand for Unrelated Donors in the Midst of the COVID-19 Pandemic: Rapid Adaptations by the National Marrow Donor Program and Its Network Partners Ensured a Safe Supply of Donor Products. Transplant Cell Ther 2021; 27:133-41. [PMID: 33830022 DOI: 10.1016/j.jtct.2020.10.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 10/26/2020] [Accepted: 10/26/2020] [Indexed: 01/10/2023]
Abstract
The impact of the coronavirus disease 2019 (COVID-19) pandemic on hematopoietic cell transplant (HCT) donor registries and transplant center (TC) practices is underreported. This article reports on the National Marrow Donor Program (NMDP) Be The Match Registry and its coordinating the provision of unrelated donor (URD) products to domestic and international TCs during the initial 3 months of the COVID-19 pandemic (March through May 2020). Specifically, NMDP data are presented for disease indications for transplant, URD search volumes and availability, graft requests and processing, courier utilization and performance, and conversion rates from formal donor search and workup to graft collection and shipment. Data following the onset of COVID-19 are compared to the immediate 3 months prior to the COVID-19 pandemic (December 2019 through February 2020) and the same quarter 1 year prior to COVID-19 (March through May 2019). During the initial onset of COVID-19 and compared to 1 year prior, TCs requested and the NMDP performed less donor searches. More multiple URD and direct to workup requests were processed by the NMDP, which likely reflected reductions in donor availability. Yet TCs continued to perform allogeneic transplants for acute disease indications like acute leukemia and myelodysplasia, using more cryopreserved grafts than before COVID-19. In comparison to prepandemic patient cycle conversion rates and durations, the NMDP was able to convert patient cycles at nearly the same or higher rates and in similar or shorter periods of time. Last, despite significant challenges caused by the pandemic, including interruptions in domestic courier services and travel restrictions, graft products were delivered to and received by TCs in similar periods of time than before COVID-19. Taken together, these data show that NMDP service line operations continued to function effectively during the early phases of the COVID-19 pandemic, ensuring requests for and delivery of URD products to domestic and international allogeneic HCT recipients.
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24
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Los-Arcos I, Iacoboni G, Aguilar-Guisado M, Alsina-Manrique L, Díaz de Heredia C, Fortuny-Guasch C, García-Cadenas I, García-Vidal C, González-Vicent M, Hernani R, Kwon M, Machado M, Martínez-Gómez X, Maldonado VO, Pla CP, Piñana JL, Pomar V, Reguera-Ortega JL, Salavert M, Soler-Palacín P, Vázquez-López L, Barba P, Ruiz-Camps I. Recommendations for screening, monitoring, prevention, and prophylaxis of infections in adult and pediatric patients receiving CAR T-cell therapy: a position paper. Infection 2020; 49:215-231. [PMID: 32979154 PMCID: PMC7518951 DOI: 10.1007/s15010-020-01521-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 08/29/2020] [Indexed: 12/11/2022]
Abstract
Chimeric antigen receptor (CAR) T-cell therapy is one of the most promising emerging treatments for B-cell malignancies. Recently, two CAR T-cell products (axicabtagene ciloleucel and tisagenlecleucel) have been approved for patients with aggressive B-cell lymphoma and acute lymphoblastic leukemia; many other CAR-T constructs are in research for both hematological and non-hematological diseases. Most of the patients receiving CAR-T therapy will develop fever at some point after infusion, mainly due to cytokine release syndrome (CRS). The onset of CRS is often indistinguishable from an infection, which makes management of these patients challenging. In addition to the lymphodepleting chemotherapy and CAR T cells, the treatment of complications with corticosteroids and/or tocilizumab increases the risk of infection in these patients. Data regarding incidence, risk factors and prevention of infections in patients receiving CAR-T cell therapy are scarce. To assist in patient care, a multidisciplinary team from hospitals designated by the Spanish Ministry of Health to perform CAR-T therapy prepared these recommendations. We reviewed the literature on the incidence, risk factors, and management of infections in adult and pediatric patients receiving CAR-T cell treatment. Recommendations cover different areas: monitoring and treatment of hypogammaglobulinemia, prevention, prophylaxis, and management of bacterial, viral, and fungal infections as well as vaccination prior and after CAR-T cell therapy.
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Affiliation(s)
- Ibai Los-Arcos
- Infectious Diseases Department, Hospital Universitari Vall D'Hebron, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gloria Iacoboni
- Deparment of Hematology, Vall D'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall D'Hebron, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - Manuela Aguilar-Guisado
- Department of Infectious Diseases, Microbiology and Preventive Medicine, University Hospital Virgen del Rocío/CSIC/Institute of Biomedicine of Seville (IBIS), Seville, Spain
| | - Laia Alsina-Manrique
- Clinical Immunology and Primary Immunodeficiencies Unit, Hospital Sant Joan de Deu, Barcelona, Spain
| | - Cristina Díaz de Heredia
- Paediatric Oncology and Hematology Department, Hematopoietic Stem Cell Transplantation, Hospital Universitari Vall D'Hebron, Barcelona, Spain
| | | | - Irene García-Cadenas
- Hematology Department, Hospital de La Santa Creu I Sant Pau, Sant Pau and Jose Carreras Leukemia Research Institutes, Autonomous University of Barcelona, Barcelona, Spain
| | - Carolina García-Vidal
- Department of Infectious Diseases, Hospital Clínic, IDIBAPS (Institut D'Investigacions biomèdiques Agust Pi I Sunyer), Universitat de Barcelona, Barcelona, Spain
| | - Marta González-Vicent
- Hematopoietic Stem Cell Transplantation and Cellular Therapy Unit, Hospital Infantil Universitario "Niño Jesus", Madrid, Spain
| | - Rafael Hernani
- Department of Hematology, Hospital Clínico Universitario, Institute for Research INCLIVA, Valencia, Spain
| | - Mi Kwon
- Haematology and Haemotherapy Department, Hospital General Universitario Gregorio Marañón, Gregorio Marañón Health Research Institute, Madrid, Spain
| | - Marina Machado
- Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Gregorio Marañón Health Research Institute, Madrid, Spain
| | - Xavier Martínez-Gómez
- Epidemiology Department, Vall D'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Valentín Ortiz Maldonado
- Department of Hematology, Hospital Clínic de Barcelona, Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), University of Barcelona, Barcelona, Spain
| | - Carolina Pinto Pla
- Infectious Diseases Unit, Hospital Clínico Universitario, Instituto de Investigación INCLIVA, Valencia, Spain
| | - José Luis Piñana
- Hematology Division, Hospital Universitario Y politécnico La Fe, Instituto de investigación sanitaria La Fe, Valencia, CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Virginia Pomar
- Infectious Disease Unit, Internal Medicine Department, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
| | - Juan Luis Reguera-Ortega
- Department of Haematology, University Hospital Virgen del Rocío/CSIC/Institute of Biomedicine of Seville (IBIS), Seville, Spain
| | - Miguel Salavert
- Infectious Diseases Unit, Área Clínica Médica, Hospital Universitario Y Politécnico La Fe, Valencia, Spain
| | - Pere Soler-Palacín
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital, Universitari Vall D'Hebron, Barcelona, Spain
| | | | - Pere Barba
- Deparment of Hematology, Vall D'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall D'Hebron, Barcelona, Spain. .,Department of Medicine, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
| | - Isabel Ruiz-Camps
- Infectious Diseases Department, Hospital Universitari Vall D'Hebron, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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25
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Zaniboni A, Ghidini M, Grossi F, Indini A, Trevisan F, Iaculli A, Dottorini L, Moleri G, Russo A, Vavassori I, Brevi A, Rausa E, Boni L, Dondossola D, Valeri N, Ghidini A, Tomasello G, Petrelli F. A Review of Clinical Practice Guidelines and Treatment Recommendations for Cancer Care in the COVID-19 Pandemic. Cancers (Basel) 2020; 12:E2452. [PMID: 32872421 PMCID: PMC7565383 DOI: 10.3390/cancers12092452] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 02/07/2023] Open
Abstract
The COVID-19 pandemic has inevitably caused those involved in cancer care to change clinical practice in order to minimize the risk of infection while maintaining cancer treatment as a priority. General advice during the pandemic suggests that most patients continue with ongoing therapies or planned surgeries, while follow-up visits may instead be delayed until the resolution of the outbreak. We conducted a literature search using PubMed to identify articles published in English language that reported on care recommendations for cancer patients during the COVID-19 pandemic from its inception up to 1st June 2020, using the terms "(cancer or tumor) AND (COVID 19)". Articles were selected for relevance and split into five categories: (1) personal recommendations of single or multiple authors, (2) recommendations of single authoritative centers, (3) recommendations of panels of experts or of multiple regional comprehensive centers, (4) recommendations of multicenter cooperative groups, (5) official guidelines or recommendations of health authorities. Of the 97 included studies, 10 were personal recommendations of single or multiple independent authors, 16 were practice recommendations of single authoritative cancer centers, 35 were recommendations provided by panel of experts or of multiple regional comprehensive centers, 19 were cooperative group position papers, and finally, 17 were official guidelines statements. The COVID-19 pandemic is a global emergency, and has rapidly modified our clinical practice. Delaying unnecessary treatment, minimizing toxicity, and identifying care priorities for surgery, radiotherapy, and systemic therapies must be viewed as basic priorities in the COVID-19 era.
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Affiliation(s)
| | - Michele Ghidini
- Oncology Unit, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy; (M.G.); (F.G.); (A.I.); (G.T.)
| | - Francesco Grossi
- Oncology Unit, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy; (M.G.); (F.G.); (A.I.); (G.T.)
| | - Alice Indini
- Oncology Unit, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy; (M.G.); (F.G.); (A.I.); (G.T.)
| | | | - Alessandro Iaculli
- Oncology Unit, ASST Bergamo Est, 24068 Seriate (BG), Italy; (A.I.); (L.D.)
| | - Lorenzo Dottorini
- Oncology Unit, ASST Bergamo Est, 24068 Seriate (BG), Italy; (A.I.); (L.D.)
| | - Giovanna Moleri
- Centro Servizi, Direzione Socio-Sanitaria, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy;
| | - Alessandro Russo
- Surgical Oncology Unit, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy;
| | - Ivano Vavassori
- Urology Unit, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy;
| | - Alessandra Brevi
- Otorhinolaryngology-Head and Neck Surgery Unit, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy;
| | - Emanuele Rausa
- General Surgery 1 Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy;
| | - Luigi Boni
- Department of Surgery, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy;
| | - Daniele Dondossola
- General and Liver Transplant Surgery Unit, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy;
- Department of Pathophysiology and Transplantation, Università degli Studi of Milan, 20122 Milan, Italy
| | - Nicola Valeri
- Division of Molecular Pathology and Centre for Evolution and Cancer, The Institute of Cancer Research, London SW7 3RP, UK;
- Department of Medicine, The Royal Marsden Hospital, London SW3 6JJ, UK
| | | | - Gianluca Tomasello
- Oncology Unit, Fondazione IRCCS–Ca’ Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy; (M.G.); (F.G.); (A.I.); (G.T.)
| | - Fausto Petrelli
- Oncology Unit, Medical Sciences Department, ASST Bergamo Ovest, 24047 Treviglio (BG), Italy
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26
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Chakraborty M, Pandey M. Caring for cancer patients in the Covid pandemic: choosing between the devil and deep sea. World J Surg Oncol 2020; 18:220. [PMID: 32828120 PMCID: PMC7443152 DOI: 10.1186/s12957-020-02002-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 08/17/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Healthcare is an essential service at any time more so in the crisis like Covid. With increase in number of cases and mortality from Covid, the primary focus is shifted to the management of the Covid crisis and other health emergencies thus affecting normal health services and routine treatment of other diseases like cancer. METHODS This article reviews the published literature and guidelines on Covid and cancer and discusses them to optimize the care of cancer patients during Covid pandemic to improve treatment outcomes. RESULTS The results of the review of published literature show a twofold increase in probability of getting CoV2 infection by the cancer patients and a four-fold increase in chance of death. On the other hand, if left untreated a 20% increase in cancer death is expected. Data further show that none of the medicines like remdesivir, hydroxy chloroquin, dexamethasone, or azithromycin improves survival and response to Covid in cancer patients. Surgical results too show similar outcome before and after the pandemic though most of these report on highly selected patients populations. CONCLUSIONS The Covid 2019 pandemic places cancer patients in a very difficult situation wherein if they seek treatment, they are exposing themselves to a risk of developing CoV2 infection and if they do not, the probability of dying without treatment increases. Hence, for them it is a choice between the devil and deep sea, and it is for the healthcare providers to triage patients and treat who cannot wait even though the data from the carefully selected cohort of patients show no increase in mortality or morbidity from treatment during Covid.
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Affiliation(s)
- Mainak Chakraborty
- Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005 India
| | - Manoj Pandey
- Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005 India
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27
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Toughza J, Agadr A, Ismaili N. [COVID-19 and hematopoietic stem cell transplantation: Recommendations]. Bull Cancer 2020; 107:741-744. [PMID: 32624167 PMCID: PMC7305863 DOI: 10.1016/j.bulcan.2020.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/23/2020] [Accepted: 05/27/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Jihane Toughza
- Mohammed VI University of Health Sciences (UM6SS), Cheick-Khalifa International University Hospital, Department of Pediatric Oncology, Casablanca, Maroc
| | - Aomar Agadr
- Service de Pédiatrie, Hôpital Militaire d'Instruction Mohammed V, Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat, Maroc
| | - Nabil Ismaili
- Mohammed VI University of Health Sciences (UM6SS), Cheick-Khalifa International University Hospital, Department of Medical Oncology, Casablanca, Maroc.
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28
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Badawy SM, Radovic A. Digital Approaches to Remote Pediatric Health Care Delivery During the COVID-19 Pandemic: Existing Evidence and a Call for Further Research. JMIR Pediatr Parent 2020; 3:e20049. [PMID: 32540841 PMCID: PMC7318926 DOI: 10.2196/20049] [Citation(s) in RCA: 138] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 06/11/2020] [Accepted: 06/14/2020] [Indexed: 12/15/2022] Open
Abstract
The global spread of the coronavirus disease (COVID-19) outbreak poses a public health threat and has affected people worldwide in various unprecedented ways, both personally and professionally. There is no question that the current global COVID-19 crisis, now more than ever, is underscoring the importance of leveraging digital approaches to optimize pediatric health care delivery in the era of this pandemic. In this perspective piece, we highlight some of the available digital approaches that have been and can continue to be used to streamline remote pediatric patient care in the era of the COVID-19 pandemic, including but not limited to telemedicine. JMIR Pediatrics and Parenting is currently publishing a COVID-19 special theme issue in which investigators can share their interim and final research data related to digital approaches to remote pediatric health care delivery in different settings. The COVID-19 pandemic has rapidly transformed health care systems worldwide, with significant variations and innovations in adaptation. There has been rapid expansion of the leveraging and optimization of digital approaches to health care delivery, particularly integrated telemedicine and virtual health. Digital approaches have played and will play major roles as invaluable and reliable resources to overcome restrictions and challenges imposed during the COVID-19 pandemic and to increase access to effective, accessible, and consumer-friendly care for more patients and families. However, a number of challenges remain to be addressed, and further research is needed. Optimizing digital approaches to health care delivery and integrating them into the public health response will be an ongoing process during the current COVID-19 outbreak and during other possible future pandemics. Regulatory changes are essential to support the safe and wide adoption of these approaches. Involving all relevant stakeholders in addressing current and future challenges as well as logistical, technological, and financial barriers will be key for success. Future studies should consider evaluating the following research areas related to telemedicine and other digital approaches: cost-effectiveness and return on investment; impact on quality of care; balance in use and number of visits needed for the management of both acute illness and chronic health conditions; system readiness for further adoption in other settings, such as inpatient services, subspecialist consultations, and rural areas; ongoing user-centered evaluations, with feedback from patients, families, and health care providers; strategies to optimize health equity and address disparities in access to care related to race and ethnicity, socioeconomic status, immigration status, and rural communities; privacy and security concerns for protected health information with Health Insurance Portability and Accountability Act (HIPAA)-secured programs; confidentiality issues for some specific populations, especially adolescents and those in need of mental health services; early detection of exposure to violence and child neglect; and integration of training into undergraduate and graduate medical education and subspecialty fellowships. Addressing these research areas is essential to understanding the benefits, sustainability, safety, and optimization strategies of telemedicine and other digital approaches as key parts of modern health care delivery. These efforts will inform long-term adoption of these approaches with expanded dissemination and implementation efforts.
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Affiliation(s)
- Sherif M Badawy
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Ana Radovic
- Department of Pediatrics, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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29
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Chhabra S, Abedin S, Graham MB, Ferrer Marrero TM, Hari PN, Shaw BE. Letter to the Editor Regarding "Diagnostic Considerations for COVID-19 in Recipients of Allogeneic Hematopoietic Cell Transplantation". Biol Blood Marrow Transplant 2020; 26:e241-e242. [PMID: 32589922 PMCID: PMC7309826 DOI: 10.1016/j.bbmt.2020.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/10/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Saurabh Chhabra
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - Sameem Abedin
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Mary Beth Graham
- Division of Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Tirsa M Ferrer Marrero
- Division of Pulmonary and Critical Care, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Parameswaran N Hari
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Bronwen E Shaw
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Center for Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin
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30
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Zomorrodi A. COVID-19 and Organ Transplantation? Int J Organ Transplant Med 2020; 11:143-144. [PMID: 32913590 PMCID: PMC7471612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- A. Zomorrodi
- Professor of urology and kidney transplant surgeon, head of organ transplantation and urology department, Tabriz medical science university
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