07.08.21

Outcome of COVID-19 in HCT patients

Ljungman P, de la Camara R, Mikulska M, et al. COVID-19 and Stem Cell Transplantation; Results From an EBMT and GETH Multicenter Prospective Survey. Leukemia. 2021; (doi: 10.1038/s41375-021-01302-5).

New research shows that COVID-19 patients who have undergone hematopoietic cell transplantation (HCT) have a high risk of developing lower respiratory tract disease (LRTD), require intensive care unit (ICU) admission, and have increased mortality. The multicenter prospective survey, which used data reported to the European Society for Blood and Marrow Transplantation and the Spanish Group of Hematopoietic Stem Cell Transplantation, involved 382 COVID-19 patients who had undergone allogeneic or autologous HCT. The patients' median age was 54.1 years for the 236 allogeneic HCT recipients and 60.6 years for the 146 autologous HCT recipients. COVID-19 infection occurred a median of 15.8 months post-HCT in allogeneic and 24.6 months in autologous recipients. Overall, 83.5% of recipients developed LRTD, and 22.5% were admitted to the ICU. Six weeks after diagnosis, survival in allogeneic and autologous patients was 77.9% and 72.1%, respectively. Survival in pediatric patients was 93.4%. Multivariate analysis demonstrated that older age, need for ICU treatment, and moderate/high immunodeficiency index increased the mortality risk, while better performance status lowered it. Factors such as underlying diagnosis, time from HCT, graft-versus-host-disease, and ongoing immunosuppression had no significant effect on overall survival.

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