Hematopoietic Cell Transplantation is Feasible in Patients with Prior COVID-19 Infection

Nishi Shah, Parastoo B. Dahi, Doris M. Ponce, Craig S. Sauter, Brian C. Shaffer, David J. Chung, Ioannis Politikos, Richard J. Lin, Sergio A. Giralt, Genovefa Papanicolaou, Lakshmi V. Ramanathan, Miguel Angel Perales, Mini Kamboj, Gunjan L. Shah, Boglarka Gyurkocza

Research output: Contribution to journalArticlepeer-review

Abstract

There are limited data on outcomes of patients with prior Coronavirus disease 2019 (COVID-19) who proceeded to autologous or allogeneic hematopoietic cell transplantation (HCT). Whether these patients are more susceptible to poor outcomes and recurrence of COVID-19 is unknown. We report a retrospective analysis of outcomes of 15 consecutive patients with hematologic malignancies who experienced COVID-19 and subsequently underwent autologous (n = 8) or allogeneic (n = 7) HCT between June 17, 2020, and February 17, 2021. The cohort included patients with asymptomatic past infections or symptomatic COVID-19 disease. Data were obtained from chart review. Descriptive statistics were used to summarize patient characteristics. Among eight patients who underwent autologous HCT, four had a diagnosis of multiple myeloma and four had a diagnosis of non-Hodgkin's lymphoma. Four of these eight patients did not test positive for anti-SARS-CoV-2 IgG antibody at any point during the course of treatment. The other four patients had detectable anti-SARS-CoV-2 IgG antibodies before undergoing autologous HCT, but only two of these patients remained anti-SARS-CoV-2 IgG antibody-positive at their last follow-up. One patient died from progression of disease. Seven patients with prior COVID-19 underwent allogeneic HCT for acute lymphoblastic leukemia (n = 3), acute myelogenous leukemia (n = 1), chronic myelogenous leukemia in lymphoid blast crisis (n = 1), myelodysplastic syndrome (n = 1), or myelofibrosis (n = 1). Three of the seven patients tested positive for anti-SARS-CoV-2 IgG antibodies following the initial COVID-19 diagnosis; however, only one of these patients retained anti-SARS-CoV-2 IgG antibody following allogeneic HCT. One patient died of infection (fungal and Pneumocystis jirovecii pneumonia) occurring in the context of ongoing treatment for graft-versus-host disease. None of the 15 patients had recurrent COVID-19 infection. Based on our experience, autologous and allogeneic HCT can be safely performed in selected patients with previous COVID-19 infection.

Original languageEnglish (US)
Pages (from-to)55.e1-55.e5
JournalTransplantation and Cellular Therapy
Volume28
Issue number1
DOIs
StatePublished - Jan 2022
Externally publishedYes

Keywords

  • COVID-19
  • Hematopoietic cell transplantation
  • SARS CoV-2
  • SARS Cov-2 antibody seroconversion

ASJC Scopus subject areas

  • Immunology and Allergy
  • Molecular Medicine
  • Hematology
  • Cell Biology
  • Transplantation

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