Impact of SARS-CoV-2 infection on graft composition and early transplant outcomes following allogeneic hematopoietic stem cell transplantation.
10.3760/cma.j.issn.0253-2727.2023.11.002
- VernacularTitle:新型冠状病毒感染对造血干细胞移植供者采集物组分以及早期疗效的影响
- Author:
Fan LIN
1
;
Hui SUN
1
;
Yao CHEN
1
;
Yuan Yuan ZHANG
1
;
Jing LIU
1
;
Yun HE
1
;
Feng Mei ZHENG
1
;
Zheng Li XU
1
;
Feng Rong WANG
1
;
Jun KONG
1
;
Zhi Dong WANG
1
;
Yuan Yuan WAN
1
;
Xiao Dong MO
1
;
Yu WANG
1
;
Yi Fei CHENG
1
;
Xiao Hui ZHANG
1
;
Xiao Jun HUANG
1
;
Lan Ping XU
1
Author Information
1. Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Key Laboratory of Hematopoietic Stem Cell Transplantation for the Treatment of Hematological Diseases, Beijing 100044, China.
- Publication Type:Journal Article
- Keywords:
Allogeneic hematopoietic stem cell transplantation;
COVID-19;
Donor;
Malignant hematological disease
- MeSH:
Humans;
COVID-19;
SARS-CoV-2;
Hematopoietic Stem Cell Transplantation;
Tissue Donors;
Graft vs Host Disease
- From:
Chinese Journal of Hematology
2023;44(11):890-899
- CountryChina
- Language:Chinese
-
Abstract:
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.
