Stringent protocols for the surveillance of infections as well as aggressive treatment measures, must be adopted in patients with COVID-19 infection receiving hematopoietic stem cells (HSCT), according to a study published in the journal Transfusion and Apheresis Science.
The study authors reported their own experience with the impact of the pandemic on HSCT activities in their center in Rome, Italy.
Read more about the treatment of myelofibrosis
They said they performed the same number of transplants during 2019 and 2020, or the first wave of the pandemic. The transplants were performed mainly in patients with acute leukemia during both years.
Transplants of cells from siblings and from cord blood units were the same in both years, but transplants by unrelated donors increased while those by haploidentical donors decreased during the pandemic. During the first wave of the pandemic, 4 patients with myelofibrosis received allogeneic HSCT.
“We decided against cryopreserving bone marrow products due to the greater risk of drastic reduction in CD34 + cell count during the process,” the researchers said. “For urgent cases with only a haploidentical donor available, we opted for the use of [peripheral blood stem cells] following stimulation with G-CSF.”
They also reported that outcomes like graft failure, sepsis, and graft versus host disease following the transplant remained the same during the pandemic.
“In accord with international guidelines, we were able to continue our HSCT program in order to ensure a lifesaving treatment for patients with hematologic diseases for whom this procedure cannot be postponed,” the researchers wrote.
HSCT is a treatment option for some patients with myelofibrosis, a rare disease characterized by bone marrow scarring caused by the production of excess fibrous tissue. This excess fibrosis interferes with the normal production of blood cells and leads to symptoms such as anemia, bleeding and bruising, fatigue, bone and joint pain, and splenomegaly.
Reference
Giammarco S, Sica S, Metafuni E, et al. Impact of Covid 19 pandemic on hematopoietic stem cell transplantation activities: report from a single center. Transfus Apher Sci. Published online March 29, 2023. doi:10.1016/j.transci.2023.103708
