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Cellular Therapy During COVID-19: Lessons Learned and Preparing for Subsequent Waves.
- Source :
-
Transplantation and cellular therapy [Transplant Cell Ther] 2021 May; Vol. 27 (5), pp. 438.e1-438.e6. Date of Electronic Publication: 2021 Feb 14. - Publication Year :
- 2021
-
Abstract
- An evidence-based triage plan for cellular therapy distribution is critical in the face of emerging constraints on healthcare resources. We evaluated the impact of treatment delays related to COVID-19 on patients scheduled to undergo hematopoietic cell transplantation (HCT) or chimeric antigen receptor T-cell (CAR-T) therapy at our center. Data were collected in real time between March 19 and May 11, 2020, for patients who were delayed to cellular therapy. We evaluated the proportion of delayed patients who ultimately received cellular therapy, reasons for not proceeding to cellular therapy, and changes in disease and health status during delay. A total of 85 patients were delayed, including 42 patients planned for autologous HCT, 36 patients planned for allogeneic HCT, and 7 patients planned for CAR-T therapy. Fifty-six of these patients (66%) since received planned therapy. Five patients died during the delay. The most common reason for not proceeding to autologous HCT was good disease control in patients with plasma cell dyscrasias (75%). The most common reason for not proceeding to allogeneic HCT was progression of disease (42%). All patients with acute leukemia who progressed had measurable residual disease (MRD) at the time of delay, whereas no patient without MRD at the time of delay progressed. Six patients (86%) ultimately received CAR-T therapy, including 3 patients who progressed during the delay. For patients with high-risk disease such as acute leukemia, and particularly those with MRD at the time of planned HCT, treatment delay can result in devastating outcomes and should be avoided if at all possible.<br /> (© 2021 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Allografts
Amyloidosis therapy
Anemia, Aplastic therapy
Civil Defense
Cross Infection epidemiology
Cross Infection prevention & control
Disease Progression
Evidence-Based Practice organization & administration
Female
Humans
Infection Control methods
Infectious Disease Transmission, Professional-to-Patient
Leukemia mortality
Leukemia pathology
Leukemia therapy
Male
Middle Aged
Myelodysplastic-Myeloproliferative Diseases mortality
Myelodysplastic-Myeloproliferative Diseases therapy
Neoplasm, Residual
Neoplasms mortality
Neoplasms therapy
New York City epidemiology
Resource Allocation
Transplantation, Autologous
Triage organization & administration
Young Adult
COVID-19 complications
COVID-19 epidemiology
COVID-19 transmission
Hematopoietic Stem Cell Transplantation statistics & numerical data
Immunotherapy, Adoptive
Pandemics
SARS-CoV-2
Time-to-Treatment statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 2666-6367
- Volume :
- 27
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Transplantation and cellular therapy
- Publication Type :
- Academic Journal
- Accession number :
- 33728417
- Full Text :
- https://doi.org/10.1016/j.jtct.2021.02.011