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Parmar G, Seftel MD, Ganz K, Blake J, Holovati JL, Allan DS. Optimizing Access to Unrelated Donors in Canada: Re-Examining the Importance of Donor Factors on Outcomes Following Hematopoietic Cell Transplantation. Curr Oncol 2024; 31:2542-2551. [PMID: 38785471 PMCID: PMC11119328 DOI: 10.3390/curroncol31050190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/17/2024] [Accepted: 04/21/2024] [Indexed: 05/25/2024] Open
Abstract
HLA-matched allogeneic hematopoietic cell transplantation (HCT) is a curative therapy for many patients. Unrelated HLA-matched donors are the most frequently used donor for HCT. When more than one donor transplant option is available, transplant centers can select donors based on non-HLA factors. With improved ability to prevent and treat immune complications, such as graft-versus-host disease and infections, it may be possible to proceed more often using HLA-mismatched donors, allowing greater consideration of non-HLA factors, such as donor age, CMV serostatus, and ABO blood group matching, which have demonstrated important impacts on transplant outcomes. Additional factors to consider are donor availability rates and the usage of domestic donors to optimize outcomes. A review of non-HLA factors and considerations on the selection of optimal unrelated donors for HCT are provided within this updated current context.
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Affiliation(s)
- Gaganvir Parmar
- Stem Cells, Canadian Blood Services, Ottawa, ON K1Z 7M3, Canada (J.B.); (J.L.H.)
- Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Matthew D. Seftel
- Stem Cells, Canadian Blood Services, Ottawa, ON K1Z 7M3, Canada (J.B.); (J.L.H.)
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC V1Y 1T3, Canada
| | - Kathy Ganz
- Stem Cells, Canadian Blood Services, Ottawa, ON K1Z 7M3, Canada (J.B.); (J.L.H.)
| | - John Blake
- Stem Cells, Canadian Blood Services, Ottawa, ON K1Z 7M3, Canada (J.B.); (J.L.H.)
- Department of Industrial Engineering, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Jelena L. Holovati
- Stem Cells, Canadian Blood Services, Ottawa, ON K1Z 7M3, Canada (J.B.); (J.L.H.)
- Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - David S. Allan
- Stem Cells, Canadian Blood Services, Ottawa, ON K1Z 7M3, Canada (J.B.); (J.L.H.)
- Department of Medicine and Biochemistry, Microbiology & Immunology, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada
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2
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Schmidt AH, Sauter J, Schetelig J, Neujahr E, Pingel J. Providing hematopoietic stem cell products from unrelated donors to the world: DKMS donor centers and DKMS Registry. Best Pract Res Clin Haematol 2024; 37:101541. [PMID: 38490766 DOI: 10.1016/j.beha.2024.101541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 03/17/2024]
Abstract
Allogeneic hematopoietic stem cell (HSC) transplantation is a curative therapy for many severe blood diseases. As many patients have no suitable family donor, large unrelated donor registries and donor centers have been established in many countries, along with an international system for the provision of unrelated donor HSC products. As an essential part of this system, DKMS operates donor centers in 7 countries with a total of 12.2 million donors and over 114,000 donations so far, and a multinational donor registry. In 2022, DKMS donors contributed 57.5% of all cross-border donations worldwide. In this review, we describe the international system for the provision of unrelated donor HSC products as well as tasks and responsibilities of donor registries and donor centers. We also discuss relevant aspects of DKMS donor centers, namely donor file composition, matching and donation probabilities and actual donations, and the unique multinational approach of the DKMS Registry.
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Affiliation(s)
- Alexander H Schmidt
- DKMS Group, Tübingen, Germany; DKMS Clinical Trials Unit, Dresden, Germany; DKMS Registry, Tübingen, Germany.
| | | | - Johannes Schetelig
- DKMS Clinical Trials Unit, Dresden, Germany; University Hospital Carl Gustav Carus, Dresden, Germany
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3
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Connelly-Smith L, Gooley T, Roberts L, Mielcarek M, Linenberger M, Petersdorf E, Sandmaier BM, Milano F. Cryopreservation of Growth Factor-Mobilized Peripheral Blood Stem Cells Does Not Compromise Major Outcomes after Allogeneic Hematopoietic Cell Transplantation: A Single-Center Experience. Transplant Cell Ther 2023; 29:700.e1-700.e8. [PMID: 37659695 DOI: 10.1016/j.jtct.2023.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 08/06/2023] [Accepted: 08/27/2023] [Indexed: 09/04/2023]
Abstract
During the Coronavirus disease 2019 pandemic, cryopreservation of allogeneic donor stem cell products ensured the availability of products at the start of conditioning for hematopoietic cell transplantation (HCT). Following recommendations from unrelated donor registries, including the National Marrow Donor Program, many centers began to cryopreserve related donor peripheral blood stem cell (PBSC) products. Throughout this process, several centers have published outcomes with cryopreserved versus fresh products, some with conflicting results. Even though cryopreservation was initially considered only a temporary measure driven by the pandemic, potential advantages include greater flexibility of transplantation timing. However, concerns about detrimental effects of cryopreservation, including increased risk of graft rejection, relapse, and consequent mortality, remained. The primary objective of the present study was to describe our center's experience comparing outcomes following PBSC transplantation with cryopreserved versus fresh grafts. This was an observational case study with a retrospective review comparing cryopreserved grafts (n = 213) to a recent historical cohort (controls) using fresh grafts (n = 167). In multivariable analyses, the adjusted hazard ratio (HR) for fresh versus cryopreserved grafts was 1.20 (95% confidence interval [CI], .79 to 1.82; P = .40) for overall mortality, .99 (95% CI, .55 to 1.77; P = .98) for nonrelapse mortality, and .94 (95% CI, .60 to 1.48; P = .80) for relapse. The adjusted HR for platelet engraftment was 1.31 (95% CI, 1.05 to 1.63; P = .02) and the odds ratio of grade III-IV acute GVHD was 1.75 (95% CI, 1.01 to 3.04; P = .05) with fresh grafts compared to cryopreserved grafts. There was no demonstrable difference in the risk of chronic GHVD. Although longer-term follow-up is needed, these data provide preliminary reassurance that in the event of another pandemic or should the logistical need arise in individual patients, cryopreservation of PBSC products is a reasonably safe alternative.
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Affiliation(s)
- Laura Connelly-Smith
- Division of Hematology, Department of Medicine, University of Washington, Seattle, Washington; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington.
| | - Ted Gooley
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Laura Roberts
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Marco Mielcarek
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington; Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, Washington
| | - Michael Linenberger
- Division of Hematology, Department of Medicine, University of Washington, Seattle, Washington; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Effie Petersdorf
- Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, Washington; Translation Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Brenda M Sandmaier
- Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, Washington; Translation Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Filippo Milano
- Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, Washington; Translation Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, Washington
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4
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Hamad L, Anthias C, Machin L. How do we forecast tomorrow's transfusion: The future of hematopoietic stem cell donation. Transfus Clin Biol 2023; 30:52-55. [PMID: 36372195 DOI: 10.1016/j.tracli.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Lina Hamad
- Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
| | | | - Laura Machin
- Lancaster Medical School, Lancaster University, Lancaster, United Kingdom; Imperial College London.
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5
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Xu LP, Lu DP, Wu DP, Jiang EL, Liu DH, Huang H, Sun ZM, Li NN, Liu QF, Zhang X, Lai YR, Song YP, Song XM, Liu SX, Zhang YC, Luo CJ, Xia LH, Niu T, Yu Y, Zhang XH, Tang XW, Luo Y, Huang XJ. Hematopoietic Stem Cell Transplantation Activity in China 2020-2021 During the SARS-CoV-2 Pandemic: A Report From the Chinese Blood and Marrow Transplantation Registry Group. Transplant Cell Ther 2023; 29:136.e1-136.e7. [PMID: 36402457 PMCID: PMC9671625 DOI: 10.1016/j.jtct.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/20/2022] [Accepted: 11/08/2022] [Indexed: 11/18/2022]
Abstract
Between 2020 and 2021, 31,525 hematopoietic stem cell transplantations (HSCTs) were reported to the Chinese Blood and Marrow Transplantation Registry Group throughout mainland China. In this report, we describe the activity and current trends for HSCT in China during the SARS-CoV-2 pandemic. In 2020, a total of 13,415 cases of HSCT were reported from 166 transplantation teams, and 75% (10,042 cases) were allogeneic HSCTs. In 2021, a total of 18,110 cases of HSCT were reported from 174 transplantation teams, and 70% (12,744 cases) were allogeneic HSCTs. Haploidentical donor (HID) transplantation accounted for 63% (7977 cases) of allogeneic HSCTs in 2021. The most common indications for allogeneic HSCT for malignant disease were acute myeloid leukemia (37%) and acute lymphoblastic leukemia (23%), and the largest proportion of nonmalignant disease comprised aplastic anemia (13%). The peripheral blood stem cell source accounted for 41% of HIDs and 75% of matched sibling donors. The BuCy-based regimen (57%) was the most popular conditioning regimen for allogeneic HSCT, followed by the BuFlu-based regimen (28%) and total body irradiation-based regimen (11%). This survey provides comprehensive information about the current activities and might benefit clinical physicians' decision planning for HSCT.
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Affiliation(s)
- Lan-Ping Xu
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Dao-Pei Lu
- Hebei Yanda Lu Daopei Hospital & Beijing Ludaopei Hospital, Langfang, Hebei & Beijing, China
| | - De-Pei Wu
- The First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Disease, Soochow, China
| | - Er-Lie Jiang
- Blood Diseases Hospital, Chinese Academy of Medical Sciences, Tianjin, China
| | | | - He Huang
- The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zi-Min Sun
- The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Nai-Nong Li
- Fujian Medical University Union Hospital, Fujian Provincial Key Laboratory of Hematology, Fujian Institute of Hematology, Fuzhou, China
| | | | - Xi Zhang
- Xinqiao Hospital of Army Medical University, Chongqing, China
| | - Yong-Rong Lai
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yong-Ping Song
- Henan Cancer Hospital, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | | | - Si-Xi Liu
- Shenzhen Children's Hospital, Shenzhen, China
| | - Yi-Cheng Zhang
- Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | | | - Ling-Hui Xia
- Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Ting Niu
- West China Hospital, Sichuan University, Chengdu, China
| | - Yu Yu
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Xiao-Hui Zhang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Xiao-Wen Tang
- The First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Disease, Soochow, China
| | - Yi Luo
- The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao-Jun Huang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
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6
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Bordat J, Maury S, Leclerc M. Allogeneic hematopoietic stem cell transplantation in the COVID-19 era. Front Immunol 2023; 14:1100468. [PMID: 36911678 PMCID: PMC9993088 DOI: 10.3389/fimmu.2023.1100468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/01/2023] [Indexed: 02/24/2023] Open
Abstract
Allogeneic hematopoietic stem-cell transplantation (allo-HSCT) recipients are especially vulnerable to coronavirus disease 19 (COVID-19), because of their profound immunodeficiency. Indeed, the first pandemic wave was marked by a high mortality rate in this population. Factors increasing immunodepression such as older age, immunosuppressive treatments or a short delay between transplant and infection appear to worsen the prognosis. Many changes in clinical practice had to be implemented in order to limit this risk, including postponing of transplant for non-malignant diseases, preference for local rather than international donations and for peripheral blood as stem cell source, and the widespread use of cryopreservation. The great revolution in the COVID-19 pandemic came from the development of mRNA vaccines that have shown to be able to prevent severe forms of the disease. More than 75% of allo-HSCT recipients develop seroconversion after 2 doses of vaccine. Multiple studies have identified lymphopenia, exposure to immunosuppressive or anti-CD20 therapies, and a short post-transplant period as factors associated with a poor response to vaccination. The use of repeated injections of the vaccine, including a third dose, not only improves the seroconversion rate but also intensifies the immune response, both in B cells and T cells. Vaccines are an effective and well-tolerated method in this high-risk population. Some studies investigated the possibility of immune protection being transferred from a vaccinated donor to a recipient, with encouraging initial results. However, dynamic mutations and immune escape of the virus can lead to breakthrough infections with new variants in vaccinated individuals and still represent a threat of severe disease in allo-HSCT recipients. New challenges include the need to adapt vaccine protection to emerging variants.
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Affiliation(s)
- Jonathan Bordat
- Hematology Department, Henri Mondor Hospital, Assistance Publique/Hôpitaux de Paris, Créteil, France
| | - Sébastien Maury
- Hematology Department, Henri Mondor Hospital, Assistance Publique/Hôpitaux de Paris, Créteil, France.,Institut Mondor de Recherche Biomédicale, équipe Immunorégulation et Biothérapies, INSERM U955, Créteil, France.,Faculté de Médecine, Paris-Est Créteil University, Créteil, France
| | - Mathieu Leclerc
- Hematology Department, Henri Mondor Hospital, Assistance Publique/Hôpitaux de Paris, Créteil, France.,Institut Mondor de Recherche Biomédicale, équipe Immunorégulation et Biothérapies, INSERM U955, Créteil, France.,Faculté de Médecine, Paris-Est Créteil University, Créteil, France
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7
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León AGD, Gil-Flores L, Colunga-Pedraza P, Bourlon C, Vargas-Serafín C, del Campo-Martínez MDLÁ, Olaya-Vargas A, Pérez-García M, González-Leal XJ, Herrera Rojas MA, Lozano-Rodríguez S, Solano-Genesta M, Rodríguez-Zúñiga AC, Sánchez-Arteaga A, Ruiz-Argüelles GJ, Gómez-Almaguer D. Hematopoietic stem cell transplantation activity in Mexico during the COVID19 pandemic: on the way to recovery. Hematology 2022; 27:1294-1300. [DOI: 10.1080/16078454.2022.2156737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Andrés Gómez-De León
- Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
| | - Lourdes Gil-Flores
- Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
| | - Perla Colunga-Pedraza
- Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
| | - Christianne Bourlon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - César Vargas-Serafín
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | | | | | - Xitlaly J. González-Leal
- Instituto Tecnológico de Estudios Superiores de Monterrey. Monterrey Nuevo León.S, Monterrey, Mexico
- Clínica Gómez-Almaguer, Monterrey
| | | | - Sergio Lozano-Rodríguez
- Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
| | | | - Anna Cecilia Rodríguez-Zúñiga
- Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
| | - Alexia Sánchez-Arteaga
- Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
| | | | - David Gómez-Almaguer
- Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
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8
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Koo J, Auletta JJ, Hartley DM, Huber J, Jaglowski S, Kapadia M, Kusnier K, Lehmann L, Maakaron J, Myers KC, Pai A, Parker L, Phelan R, Sper C, Rotz SJ, Dandoy CE. Secondary Impact of the Coronavirus Disease 19 Pandemic on Patients and the Cellular Therapy Healthcare Ecosystem. Transplant Cell Ther 2022; 28:737-746. [PMID: 35902050 PMCID: PMC9313529 DOI: 10.1016/j.jtct.2022.07.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 11/24/2022]
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has significantly impacted global health and healthcare delivery systems. To characterize the secondary effects of the COVID-19 pandemic and mitigation strategies used in the delivery of hematopoietic stem cell transplantation (HSCT) care, we performed a comprehensive literature search encompassing changes in specific donor collection, processing practices, patient outcomes, and patient-related concerns specific to HSCT and HSCT-related healthcare delivery. In this review, we summarize the available literature on the secondary impacts the COVID-19 pandemic on the fields of HSCT and cellular therapy. The COVID-19 pandemic has had numerous secondary impacts on patients undergoing HSCT and the healthcare delivery systems involved in providing complex care to HSCT recipients. Institutions must identify these influences on outcomes and adjust accordingly to maintain and improve outcomes for the transplantation and cellular therapy community.
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Affiliation(s)
- Jane Koo
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio.
| | - Jeffrey J Auletta
- Center for International Blood and Marrow Transplant Research, Milwaukee, Wisconsin; Hematology/Oncology/BMT and Infectious Diseases, Nationwide Children's Hospital, Columbus, Ohio
| | - David M Hartley
- Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio; James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - John Huber
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio
| | - Samantha Jaglowski
- Division of Hematology-Oncology and Transplantation; Department of Pediatrics, Ohio State University Medical Center, Columbus, Ohio
| | - Malika Kapadia
- Division of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Department of Pediatrics, Harvard University Medical School, Boston, Massachusetts
| | - Katilyn Kusnier
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio
| | - Leslie Lehmann
- Division of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Department of Pediatrics, Harvard University Medical School, Boston, Massachusetts
| | - Joseph Maakaron
- Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Kasiani C Myers
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio
| | - Ahna Pai
- Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio; Department of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Loretta Parker
- Division of Hematology/Oncology, Department of Pediatrics, The University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
| | - Rachel Phelan
- Division of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Department of Pediatrics, Medical College of Wisconsin and Children's Wisconsin, Milwaukee, Wisconsin
| | - Christine Sper
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Seth J Rotz
- Department of Pediatric Hematology, Oncology, and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio
| | - Christopher E Dandoy
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio
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9
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Farhadfar N, Newman J, Novakovich J, Barten J, Ndifon ET, Oakes J, Cody M, Pham HP, Auletta JJ, Miller JP, Devine SM, Stefanski HE. Neither COVID-19, nor cryopreservation, prevented allogeneic product infusion: A report from the National Marrow Donor Program. Front Immunol 2022; 13:937900. [PMID: 36203566 PMCID: PMC9531692 DOI: 10.3389/fimmu.2022.937900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background The Coronavirus Disease 2019 (COVID-19) pandemic in early 2020 has resulted in an unprecedented level of uncertainty and challenge for the stem cell donor registries. To address these challenges, rapid strategies were implemented by the National Marrow Donor Registry (NMDP) and its network partners. Herein, we aim to report the impact of the COVID-19 pandemic on the collection, utilization of grafts, and short-term outcomes of patients who received stem cell products from COVID-19-positive donors. Methods NMDP data during the early phase (1 March 2020 through 1 May 2020) of the pandemic were compared to the later phase (1 March 2021 through 1 May 2021). Odds ratios were calculated to determine the impact of the pandemic on graft sources requested by transplant centers (TCs). The Kruskal–Wallis test was used to test the effect of the pandemic on the disease indication, volume of searches, and number of products not infused. Results Although there was an initial decline in overall donor searches during the early phase of the pandemic, these numbers increased reaching pre-pandemic levels during the later phase. Urgent malignant diseases remained the most common indication for transplant in 2021. The pandemic necessitated cryopreservation of stem cell products due to transportation restrictions as well as clinical uncertainties in managing the virus. Cryopreserved grafts remained the most common requested grafts throughout the pandemic. In the later phase of the pandemic, the total numbers of requests for fresh grafts increased, mostly due to the increase in requests for fresh bone marrow (BM) grafts. As the pandemic continued, TCs became more accepting of cryopreservation, resulting in a reduction in the number of products not infused. Lastly, no short-term deleterious outcomes were noted among the patients who had stem cell products infused from a SARS-CoV-2-positive donor. Conclusion Throughout the pandemic, the NMDP and TCs worked tirelessly to ensure that patients would receive lifesaving grafts when needed. The data reported here, although limited by small numbers, illustrate that transplantation from donors with COVID-19 is feasible and safe.
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Affiliation(s)
| | - Jeni Newman
- National Marrow Donor Program/Be the Match, Minneapolis, MN, United States
| | | | - Jacklyn Barten
- National Marrow Donor Program/Be the Match, Minneapolis, MN, United States
| | - Eric T. Ndifon
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be the Match, Minneapolis, MN, United States
| | - Jason Oakes
- National Marrow Donor Program/Be the Match, Minneapolis, MN, United States
| | - Meghann Cody
- National Marrow Donor Program/Be the Match, Minneapolis, MN, United States
| | - Huy P. Pham
- National Marrow Donor Program/Be the Match, Minneapolis, MN, United States
| | - Jeffery J. Auletta
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be the Match, Minneapolis, MN, United States
- Nationwide Children’s Hospital, Columbus, OH, United States
| | - John P. Miller
- National Marrow Donor Program/Be the Match, Minneapolis, MN, United States
| | - Steven M. Devine
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be the Match, Minneapolis, MN, United States
| | - Heather E. Stefanski
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be the Match, Minneapolis, MN, United States
- *Correspondence: Heather E. Stefanski,
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10
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Blandin L, Tolmer E, Hermet E, Ravinet A, Brebion A, Lemal R, Rouzaire P. COVID-19 systematic screening of asymptomatic haematopoietic stem cell donors: Less if often more. EJHAEM 2022; 3:JHA2556. [PMID: 36248619 PMCID: PMC9538191 DOI: 10.1002/jha2.556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/09/2022] [Accepted: 08/15/2022] [Indexed: 11/20/2022]
Abstract
From COVID pandemic spread until now, many HSCT unrelated donor registries recommend as a precaution a systematic COVID-19 testing for all donors during the precollection time. Literature is quite poor to support this systematic attitude. We report one sibling allogeneic HSCT which we proceeded despite a positive COVID test on related asymptomatic donor and summarize the all seven cases reported until now. We suggest to question this systematic COVID testing, two years after pandemic began, when there is no systematic testing on other blood products received during all the haematological malignancies treatment process.
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Affiliation(s)
- Lucie Blandin
- Histocompatibility and Immunogenetics LaboratoryClermont‐Ferrand University HospitalClermont‐FerrandFrance
| | - Elise Tolmer
- Histocompatibility and Immunogenetics LaboratoryClermont‐Ferrand University HospitalClermont‐FerrandFrance
| | - Eric Hermet
- Cellular Therapy and Clinical Haematology DepartmentClermont‐Ferrand University HospitalClermont‐FerrandFrance
| | - Aurélie Ravinet
- Cellular Therapy and Clinical Haematology DepartmentClermont‐Ferrand University HospitalClermont‐FerrandFrance
| | - Amélie Brebion
- Virology LaboratoryClermont‐Ferrand University HospitalClermont‐FerrandFrance
| | - Richard Lemal
- Histocompatibility and Immunogenetics LaboratoryClermont‐Ferrand University HospitalClermont‐FerrandFrance
- EA7453 CHELTERClermont‐Auvergne UniversityClermont‐FerrandFrance
| | - Paul Rouzaire
- Histocompatibility and Immunogenetics LaboratoryClermont‐Ferrand University HospitalClermont‐FerrandFrance
- EA7453 CHELTERClermont‐Auvergne UniversityClermont‐FerrandFrance
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11
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Jagelaviciute G, Kum E, Li EW, Rosenfeld A, Williams K, Kandel R, DeGurse N, Park B, Okonofua S, Sano L, Gerofsky M, Sharp A, Hatkar R, Thyagu S, Fingrut WB. Why We Swab: A library of stories in stem cell donation. Transfusion 2022; 62:2095-2107. [PMID: 36062961 DOI: 10.1111/trf.17087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 06/30/2022] [Accepted: 07/13/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Stories are powerful in their ability to disseminate information in a meaningful way. We hypothesized that a stem cell donation story library optimized for social media could support the education and recruitment of committed unrelated hematopoietic stem cell donors from needed demographic groups. STUDY DESIGN AND METHODS We developed Why We Swab, a library of stories on stem cell donation (facebook.com/WhyWeSwab; instagram.com/WhyWeSwab; twitter.com/WhyWeSwab), and evaluated its impact across social and traditional media as well as on eligible potential donors' knowledge and attitudes towards donation. RESULTS As of December 2021, the library included 28 story arcs featuring 45 storytellers from diverse ancestral backgrounds, including 8 donor-recipient stories. Overall, the stories reached >92,000 people across social media. Notably, stories were republished by 18 print/ broadcast media outlets in Canada and by major medical organizations. A series of stories shown to 33 eligible potential donors improved mean total scores on a donation knowledge test (64% to 85%, p < 0.001), reduced mean ambivalence scale scores (3.85 to 2.70, p < 0.001), and improved participants' willingness to register as donors (45% to 73%, p < 0.005). Data are also shown demonstrating that stakeholders valued the library and that its deployment was associated with improved donor recruitment outcomes in Canada. CONCLUSION Why We Swab is accessible and relevant to a wide audience, including stem cell donor registries and recruitment organizations seeking to improve their recruitment efforts as well as to blood and organ & tissue donation organizations who can adapt the Why We Swab model to their audiences.
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Affiliation(s)
- Gabriele Jagelaviciute
- Stem Cell Club, Toronto, Ontario, Canada.,School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Elena Kum
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Edward W Li
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Health Sciences and Wellness, Humber College, and University of New Brunswick, Toronto, Ontario, Canada
| | - Aaron Rosenfeld
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Kenneth Williams
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rana Kandel
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Natalie DeGurse
- Stem Cell Club, Toronto, Ontario, Canada.,Schulich School of Medicine, Western University, London, Ontario, Canada
| | - Brady Park
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Science, Western University, London, Ontario, Canada
| | - Sylvia Okonofua
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Science, University of Regina, Regina, Saskatchewan, Canada
| | - Lauren Sano
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Science, Western University, London, Ontario, Canada
| | - Moriah Gerofsky
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Health Sciences, University of Wilfrid Laurier, Waterloo, Ontario, Canada
| | - Alexander Sharp
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Rupal Hatkar
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Santhosh Thyagu
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Warren B Fingrut
- Stem Cell Club, Toronto, Ontario, Canada.,Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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12
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Odom E, Nakajima Y, Vellano K, Al-Araji R, Coleman King S, Zhang Z, Merritt R, McNally B. Trends in EMS-attended Out-of-Hospital Cardiac Arrest Survival, United States 2015-2019. Resuscitation 2022; 179:88-93. [DOI: 10.1016/j.resuscitation.2022.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 12/29/2022]
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13
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Impact of Cryopreservation of Peripheral Blood Stem Cells (PBSC) in Transplantation from Matched Unrelated Donor (MUD). J Clin Med 2022; 11:jcm11144114. [PMID: 35887878 PMCID: PMC9320435 DOI: 10.3390/jcm11144114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/09/2022] [Accepted: 07/13/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Cryopreservation of PBSC for allogenic hematopoietic stem cell transplantation (allo-HSCT) was implemented due to the current Coronavirus 2019 pandemic. The impact of match unrelated donor (MUD) graft freezing on the outcome of allo-HSCT in terms of hematological recovery, graft versus host disease (GVHD), and survival are still controversial. Methods: In this study, we compared graft composition, clinical characteristics, and outcome of 31 allo-HSCT from MUD cryopreserved PBSC (Cryo Group) with 23 matched-pair allo-HSCT from fresh MUD PBSC (Fresh Group) performed in our center between January 2020 and July 2021. Results: No significant differences were recognized in clinical characteristics of patients, donors, and transplants between the Cryo and Fresh groups except for a better prognostic comorbidity index (HCT-CI) of the Cryo group. In the Cryo Group, the median time from apheresis to cryopreservation was 46.0 h (range 23.8−53.5), while the median time from cells collection and reinfusion was 13.9 days (range 5.8−28.1). In the Fresh Group, median time from apheresis to reinfusion was 35.6 h (range 21.4−51.2). The number of viable (7-AAD negative) CD34+ cells per kg patient infused was significantly lower in the Cryo Group (5.2 ± 1.9 × 106/kg vs. 7.0 ± 1.3 × 106/kg; p < 0.001). Indeed, there was a 36% (11−70) median loss of viable CD34+/kg cells after freezing. All patients engrafted: median time to neutrophil engraftment (>0.5 × 109/L) was 13.5 days (range 12−15) for Cryo Group and 14 days (range 13−16) days for Fresh Group (p = 0.522), while the median time to platelet engraftment (>20 × 109/L) was, respectively, 14 (range 12−18) and 15 (range 12−17) days (p = 0.904). The incidence of grade ≥ 2 acute GVHD was similar in the two groups (56.5% Cryo Group vs. 60.0% Fresh Group; p = 0.832) and no differences in terms of OS (p = 0.090), PFS (p = 0.200) and TRM (p = 0.970) were observed between the Cryo and Fresh groups. Conclusions: In our series, no differences between the Cryo and Fresh groups were found in engraftment, grade ≥ 2 acute GVHD incidence, OS, PFS, and TRM despite a lower CD34+ infused dose in the Cryo Group. Frozen PBSCs could be considered a safe option also for allo-HSCT from MUD but a higher amount of PBSC should be collected to warrant an adequate viable CD34+ post-thawing.
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14
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Othman J, Aarons D, Bajel A, Butler J, Doocey R, O'Brien T, Purtill D, Smith L, Wilcox L, Hamad N. Allogeneic haematopoietic cell transplant services in Australia and New Zealand in the first year of the COVID-19 pandemic: A report from Australia and New Zealand Transplant and Cellular Therapies. Intern Med J 2022; 53:323-329. [PMID: 35833788 PMCID: PMC9349380 DOI: 10.1111/imj.15886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 07/03/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The COVID-19 pandemic has caused major disruption to health systems, with allogeneic haematopoietic cell transplant (alloHCT) services a particularly vulnerable area. Ongoing provision of alloHCT has required dynamic responses at national and local levels. In Australia and New Zealand (ANZ), a high reliance on unrelated donors from overseas registries has posed an additional challenge. AIMS To describe the impact of COVID-19 on alloHCT services in ANZ in the first year of the pandemic. METHODS Data from the national alloHCT recipient and unrelated donor registries was extracted for a 2-year time frame. Comparisons were made between a pre-pandemic period of 1st March 2019 to 29th February 2020 and the corresponding dates during the pandemic, 1st March 2020 to 28th February 2021. RESULTS There was a 13% decrease in the number of allogeneic transplants, a reversal of steady increases in previous years, with the largest decrease in unrelated donor transplants. Local donors supplied a greater proportion of unrelated stem cell products. With a switch to universal cryopreservation, the time from request of a product to infusion increased by a median of 25.5 days for overseas products and 14 days for local products. There was a significant increase in the number of products collected but not used. CONCLUSIONS A strong public health response and coordinated transplant community activities allowed for safe provision of alloHCT in ANZ, however our data suggests that the timely delivery of allogeneic transplants was affected by the COVID-19 pandemic. Continued dedicated efforts are required to minimise further impacts. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jad Othman
- Department of Haematology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Donna Aarons
- Australasian Bone Marrow Transplant Recipient Registry, St. Vincent's Hospital, Darlinghurst, New South Wales, Australia
| | - Ashish Bajel
- Department of Haematology, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Melbourne, Australia
| | - Jason Butler
- Department of Bone Marrow Transplantation, Royal Brisbane and Women's Hospital, Brisbane, QLD
| | - Richard Doocey
- Department of Haematology, Auckland City Hospital, Auckland
| | - Tracey O'Brien
- Blood & Marrow Transplant Program, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
| | - Duncan Purtill
- Blood and Marrow Transplant Program, Fiona Stanley Hospital, Perth, Australia
| | - Lisa Smith
- Australian Bone Marrow Donor Registry, Sydney, New South Wales, Australia
| | - Leonie Wilcox
- Australasian Bone Marrow Transplant Recipient Registry, St. Vincent's Hospital, Darlinghurst, New South Wales, Australia
| | - Nada Hamad
- Department of Haematology, St Vincent's Hospital, Sydney, Australia.,St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Australia.,School of Medicine Sydney, University of Notre Dame Australia, Australia
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15
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Allan DS, Green M, Morris G, Weiss J, Dibdin N, Mercer D, Seftel M. Demand and usage of unrelated donor products for allogeneic haematopoietic cell transplantation during the COVID-19 pandemic: A Canadian Blood Services Stem Cell Registry analysis. Vox Sang 2022; 117:1121-1125. [PMID: 35583125 PMCID: PMC9347538 DOI: 10.1111/vox.13294] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/31/2022] [Accepted: 04/27/2022] [Indexed: 11/29/2022]
Abstract
Background and Objectives Understanding changes in the demand and usage of unrelated allogeneic haematopoietic cell transplantation (HCT) donors during the COVID‐19 pandemic is needed to optimize pandemic preparedness of registry and donor collection services. The aim of this study was to understand the extent to which the pandemic has impacted the demand and usage of unrelated donors and cord blood units (CBUs) at Canadian Blood Services (CBS). Materials and Methods Data regarding stem cell donor interest and product usage for unrelated allogeneic HCT were retrieved from the database at CBS using de‐identified anonymous information. Results Unrelated donor searches for Canadian patients remained unchanged by the pandemic, reflecting stable demand. The number of unrelated allogeneic transplants performed within Canada also remained stable, while the number of cord blood transplants increased, chiefly for paediatric patients. Requests for donor verification typing, a first signal of potential interest, increased from domestic centres during the first 6 months of the pandemic and decreased from international centres, before returning to baseline levels. The proportion of transplants for Canadian patients who used stem cell products procured from Canadian donors increased between 3 and 6 months after the start of the pandemic before returning to baseline and appears to be increasing again more than 1 year after the start of the pandemic. Use of CBUs for Canadian paediatric patients increased and remains elevated. Conclusion Demand for unrelated adult HCT donors has remained stable despite the evolving pandemic with a transient and recurring increased interest and usage of domestic adult donors. Use of CBUs for paediatric patients has increased and remains elevated. Registries and donor collection centres should maintain the capacity to expand services for domestic donor collection during pandemics to offset threats to international donor usage.
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Affiliation(s)
- David S Allan
- Stem Cells, Canadian Blood Services, Ottawa, Ontario, Canada.,Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Department of Medicine and Biochemistry, Microbiology & Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Meagan Green
- Stem Cells, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Gail Morris
- Stem Cells, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Jason Weiss
- Stem Cells, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Nicholas Dibdin
- Stem Cells, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Dena Mercer
- Stem Cells, Canadian Blood Services, Ottawa, Ontario, Canada
| | - Matthew Seftel
- Stem Cells, Canadian Blood Services, Ottawa, Ontario, Canada.,Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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16
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Impact of COVID-19 pandemic on global unrelated stem cell donations in 2020—Report from World Marrow Donor Association. Bone Marrow Transplant 2022; 57:1021-1024. [PMID: 35397653 PMCID: PMC8994088 DOI: 10.1038/s41409-022-01667-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/22/2022] [Accepted: 03/29/2022] [Indexed: 11/29/2022]
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17
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Janowiak-Majeranowska A, Lebiedziński F, Majeranowski A. Bone marrow donation in Poland: 2021 update, and the impact of the coronavirus disease 2019 pandemic on haematopoietic stem cell transplantation. CLINICAL ETHICS 2022; 17:22-31. [PMID: 35250386 PMCID: PMC8819559 DOI: 10.1177/14777509211036643] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Haematopoietic stem cell transplantation is a treatment modality that saves the
health and lives of a growing number of patients around the world. In the
majority of cases, the procedure is conducted to treat haematologic neoplasms,
although it can also be used as a therapy for some non-haematooncological
diseases. The progress that has been taking place in the field of haematopoietic
stem cell transplantation involves the need for recruiting more and more
potential unrelated bone marrow donors for allotransplantation. In Poland, the
number of people registering as potential bone marrow donors has been
continuously growing and in order to maintain this trend, it is necessary, above
all, to consistently spread the noble idea of bone marrow donation and to raise
Poles’ awareness and knowledge about haematopoietic stem cell transplantation.
Unfortunately, the situation caused by the severe acute respiratory syndrome
coronavirus 2 pandemic limited the opportunities to act in public space and, as
a consequence, it has become more difficult to achieve the objectives associated
with recruiting new potential donors. The article provides a presentation of
ethical and practical aspects associated with bone marrow donations as well as
an overview of the legal situation concerning bone marrow donating and
transplantation in Poland. The purpose of the paper is to also present some of
the changes in transplantation procedures that have emerged as a consequence of
the current epidemiological situation. The authors would like to emphasize the
importance and the rightfulness of taking action that enables further
development of transplantology.
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Affiliation(s)
| | | | - Alan Majeranowski
- Department of Hematology and Transplantology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.,Department of Cell Biology and Immunology, Intercollegiate Faculty of Biotechnology, University of Gdańsk and Medical University of Gdańsk, Gdańsk, Poland
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18
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Fingrut WB, Chen AC, Green M, Weiss JT, Mercer D, Allan D. Development and evaluation of checklists to support the recruitment of committed hematopoietic stem cell donors. Transfusion 2022; 62:887-896. [PMID: 35182432 DOI: 10.1111/trf.16827] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Checklists are memory recall tools used across healthcare to improve outcomes. Here, we describe the development and evaluation of checklists to support recruitment of committed allogeneic hematopoietic stem cell donors. STUDY DESIGN AND METHODS Checklists were developed with the following objectives: (1) improve best-practice adherence; (2) reduce errors; and (3) support standardization at stem cell drives. Topics included: recruiting needed donors; securing informed consent; maintaining good-documentation practices; and supervising registration and tissue sample collection. Checklists were iteratively revised with input from stakeholders. We evaluated the checklists by examining recruitment outcomes and errors (i.e., preventing registrants from being listed as donors) pre- (11/2011-8/2016) and post- (9/2016-11/2019) implementation by the Canadian donor recruitment organization Stem Cell Club. Quantitative and qualitative methods were employed to analyze recruiters' perspectives on the checklists. RESULTS The checklists supported recruitment of donors from needed demographic groups as Stem Cell Club expanded its recruitment effort from 4118 registrants (60% male, 58% non-European) pre-implementation to 10,621 (52% male, 56% non-European) post-implementation. Checklist implementation was associated with a marked reduction in errors (from 13.2% to 1.9%) and a three-fold increase in the match rate of recruited donors (from 0.024% to 0.075%). Qualitative and quantitative analysis of recruiter feedback supported that the checklists' objectives were realized from the recruiter perspective. DISCUSSION We developed checklists to support donor recruitment and showed that their implementation was valued by recruiters and associated with both reduced errors and improved donor recruitment outcomes. The checklists are relevant to donor recruitment organizations worldwide.
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Affiliation(s)
- Warren B Fingrut
- Stem Cell Club, Toronto, ON, Canada.,Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Angela C Chen
- Stem Cell Club, Toronto, ON, Canada.,Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
| | - Meagan Green
- Canadian Blood Services, Ottawa, Ontario, Canada
| | | | - Dena Mercer
- Canadian Blood Services, Ottawa, Ontario, Canada
| | - David Allan
- Canadian Blood Services, Ottawa, Ontario, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Clinical Epidemiology & Regenerative Medicine, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
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19
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Severe acute respiratory syndrome coronavirus 2 infection in the stem cell transplant recipient - clinical spectrum and outcome. Curr Opin Infect Dis 2021; 34:654-662. [PMID: 34751184 PMCID: PMC8577303 DOI: 10.1097/qco.0000000000000790] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Focusing on large multicenter cohorts reported over the last months, this review aims at summarizing the available evidence by July 2021 on the impact of coronavirus disease 2019 (COVID-19) on hematopoietic stem cell transplant (HSCT) recipients in terms of epidemiology, clinical features, and outcome. RECENT FINDINGS The incidence of COVID-19 in institutional cohorts varied according to different regions and study periods from 0.4% to 8.3%. Clinical presentation was overall comparable to other immunocompromised hosts and the general population. Microbiologically confirmed superinfection occurred in 13-25% of recipients, with most episodes due to hospital-acquired bacteria and few reported cases of COVID-19-associated aspergillosis. Prolonged nasopharyngeal severe acute respiratory syndrome coronavirus 2 shedding has been demonstrated for as long as 210 days. Mortality rates were similar across studies (14.8-28.4%) and did not markedly differ from those observed in nontransplant hematological patients during the first wave. Older age and shorter time from transplantation were associated with mortality, as well as underlying disease status and amount of immunosuppression. No outcome differences were found in most studies between allogeneic and autologous procedures. SUMMARY Considerable advances have been achieved in the characterization of COVID-19 in the HSCT population, although uncertainties remain in the optimal therapeutic management.
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20
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Javed R, Roychowdhury M, Bhave S, Nag A, Kumar J, Radhakrishnan V, Bhattacharya S, Mishra DK, Ghara N, RS R, Nair R, Chandy M. Impact of COVID-19 on peripheral stem cell collection and preservation at a hematopoietic cell transplant center in India: Experience 2020. BLOOD CELL THERAPY 2021; 4:84-87. [PMID: 36714064 PMCID: PMC9847266 DOI: 10.31547/bct-2021-004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/16/2021] [Indexed: 02/01/2023]
Abstract
The prevailing corona virus disease 19 (COVID-19) pandemic has adversely affected the healthcare services globally. Hematopoietic cell transplantation (HCT) is considered as the preferred treatment option for several hematological malignancies, and HPC collection facilities have to function continuously along with implementing safety measures. Based on the national and international guidelines, we implemented additional measures and modifications to our standard operating procedure (SOP) to ensure secure HPC collection from patients as well as donors. Here, we report our experience with HPC collection and processing from 1st January, 2020 until 31st December, 2020. We collected 59 HPC products through apheresis and 41 cryopreservation procedures. Compared to 2019, there was a 33% decrease in the number of HPC transplants and 31% reduction in HPC collection procedures. However, we report an 86% (13 procedures) increase in the cryopreservation of HPC products from related donors, as several organizations recommend cryopreservation of HPC products. We report our institutional experience to better understand the impact of COVID-19 on HCT services in a tertiary care center in the developing world. It may also help in being prepared for any future waves of COVID-19 cases.
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Affiliation(s)
- Rizwan Javed
- Apheresis & Cell processing unit, Department of Clinical Haematology and BMT, TATA Medical Center, Kolkata
| | | | - Saurabh Bhave
- Department of Clinical Haematology and BMT, TATA Medical Center, Kolkata
| | - Arijit Nag
- Department of Clinical Haematology and BMT, TATA Medical Center, Kolkata
| | - Jeevan Kumar
- Department of Clinical Haematology and BMT, TATA Medical Center, Kolkata
| | | | | | | | - Niharendu Ghara
- Department of Paediatric Haemato-Oncology, TATA Medical Center, Kolkata
| | - Reghu RS
- Department of Paediatric Haemato-Oncology, TATA Medical Center, Kolkata
| | - Reena Nair
- Department of Clinical Haematology and BMT, TATA Medical Center, Kolkata
| | - Mammen Chandy
- Department of Clinical Haematology and BMT, TATA Medical Center, Kolkata
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21
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Kum E, Jagelaviciute G, Chen AC, Baharmand I, Rihani S, Rumball G, Patel D, Kandel R, Okonofua S, Li EW, Hrycyshyn A, Chan SWS, Kumar SV, Williams K, Prokosch L, Ho M, Park B, Fingrut W. Development and evaluation of a community of practice to improve stem cell donor recruitment in Canada. Vox Sang 2021; 117:587-596. [PMID: 34725827 DOI: 10.1111/vox.13211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 11/27/2022]
Abstract
Background and Objectives Communities of practice (CoPs) represent effective models to achieve quality outcomes in health care. We report the development and evaluation of a CoP to improve stem cell donor recruitment in Canada. Materials and Methods In September 2017, we invited national stakeholders in stem cell donor recruitment to participate in a Facebook group and regular e-meetings. E-meetings involved speakers and roundtable discussion on topics related to donor recruitment. The Facebook group facilitated sharing of resources. We evaluated stakeholder perspective of the CoP and the impact on recruitment outcomes. Results As of December 2020, the CoP included 382 members who published 243 posts to the Facebook group about patient/donor stories (40%), resources (27%), updates/questions (21%) and recruitment outcomes (12%). In January 2020, we surveyed 44 CoP participants; the majority felt that the Facebook group (86%) and e-meetings (59%) supported the community, and that the CoP fostered collaboration (82%), improved their donor recruitment knowledge (75%) and practice (77%) and improved their ability to recruit needed donors (64%). The launch of the CoP correlated with improved donor recruitment outcomes. In 2016-2017, CoP participants recruited 2918 registrants (46% male; 55.9% non-Caucasian) compared to 4531 registrants in 2018-2019 (52.9% male; 62.7% non-Caucasian). Members of the CoP developed innovative resources to support recruitment efforts and led national campaigns securing coverage in major media outlets. Conclusion We describe the first CoP in stem cell donor recruitment to be formally evaluated. The CoP model may be adopted by donor recruitment organisations, registries and blood banks worldwide to improve recruitment outcomes. HIGHLIGHTS: • A community of practice (CoP) in stem cell donor recruitment was valued by participants and supported efforts to improve recruitment outcomes. • The CoP model may be adopted by donor recruitment organizations, donor registries, and blood banks worldwide to improve recruitment outcomes.
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Affiliation(s)
- Elena Kum
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Gabriele Jagelaviciute
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Angela C Chen
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
| | - Iman Baharmand
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Samer Rihani
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Science, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Gabriella Rumball
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Science, Laurentian University, Sudbury, Ontario, Canada
| | - Div Patel
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Science, Laurentian University, Sudbury, Ontario, Canada
| | - Rana Kandel
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Sylvia Okonofua
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Science, University of Regina, Regina, Saskatchewan, Canada
| | - Edward W Li
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Adriyan Hrycyshyn
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Sze Wah Samuel Chan
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Shamini Vijaya Kumar
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kenneth Williams
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lillie Prokosch
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Science, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Michelle Ho
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Science, Western University, London, Ontario, Canada
| | - Brady Park
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Science, Western University, London, Ontario, Canada
| | - Warren Fingrut
- Stem Cell Club, Toronto, Ontario, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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22
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Abstract
PURPOSE OF REVIEW Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) impacted every facet of hematopoietic cell transplantation. This article reviews the adjustments to recipient and donor care that occurred in response to this unprecedented event. RECENT FINDINGS Transplant centers modified algorithms, patient flow, education, and how we provided care. Our donor center partners reworked how donors were evaluated and products delivered to the transplant center. Our professional societies provided guidelines for patient and donor care and rapidly modified these based upon the never-ending stream of new data learned about SARS-CoV-2. Our research organizations provided rapid analyses to ensure the care modifications necessitated did not have a profound negative impact on our patients or donors. SUMMARY The efforts of transplant providers and donor centers worldwide allowed patients to receive the transplant needed with assurances that they were receiving the best care available despite the worldwide challenge.
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Affiliation(s)
- Marcie Riches
- Division of Hematology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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23
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Prevalence and correlates of psychological distress, unmet supportive care needs, and fear of cancer recurrence among haematological cancer patients during the COVID-19 pandemic. Support Care Cancer 2021; 29:7755-7764. [PMID: 34164740 PMCID: PMC8221273 DOI: 10.1007/s00520-021-06369-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 06/15/2021] [Indexed: 11/28/2022]
Abstract
Background The COVID-19 pandemic has had a disruptive effect on people with haematological cancers, who represent a high-risk population due to the nature of their disease and immunosuppressive treatments. We aimed to identify the psychological impacts of the COVID-19 pandemic on haematology patients and identify correlated factors to inform the development of appropriate supportive interventions. Methods Three hundred and ninety-four respondents volunteered their participation in response to a study advertisement distributed online through established haematology groups. Participants completed a self-report online survey exploring wellbeing, psychological distress, unmet supportive care needs, and fear of cancer recurrence. Results At least 1 in 3 respondents (35%) reported clinical levels of distress and nearly 1 in 3 (32%) identified at least one unmet need. Among respondents in remission (n = 134), clinical fear of cancer recurrence was reported by nearly all (95%). Unmet needs, pre-existing health conditions, younger age, financial concerns, and perceived risk of contracting COVID-19 were the dominant factors contributing to psychological distress during the pandemic. Psychological distress, lost income, perceived inadequate support from care team, perceived risk of contracting COVID-19, and being a woman were significantly associated with unmet needs. Psychological distress and concern about the impact of COVID-19 on cancer management were significantly associated with fear of cancer recurrence among respondents in remission. Conclusion Results highlight the high psychological burden and unmet needs experienced by people with haematological cancers during the COVID-19 pandemic and indicate a need for innovative solutions to rapidly identify distress and unmet needs during, and beyond, pandemic times. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-021-06369-5.
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24
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Schmidt AH, Buk D, Bernas SN, Mengling T, Neujahr E, Brink MRM. A DKMS (German Bone Marrow Donor Center) view on cryopreservation of unrelated donor stem cell products during the Covid-19 pandemic. Am J Hematol 2021; 96:E91-E92. [PMID: 33368593 PMCID: PMC7898391 DOI: 10.1002/ajh.26081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 11/25/2022]
Affiliation(s)
| | | | | | | | | | - Marcel R. M. Brink
- Adult Bone Marrow Transplantation Service, Department of Medicine Memorial Sloan Kettering Cancer Center New York USA
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25
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Russo D, Polverelli N, Malagola M, Farina M, Leoni A, Bernardi S, Mammoliti S, Sacchi N, Martino M, Ciceri F. Changes in Stem Cell Transplant activity and procedures during SARS-CoV2 pandemic in Italy: an Italian Bone Marrow Transplant Group (GITMO) nationwide analysis (TransCOVID-19 Survey). Bone Marrow Transplant 2021; 56:2272-2275. [PMID: 33875810 PMCID: PMC8054130 DOI: 10.1038/s41409-021-01287-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 03/09/2021] [Accepted: 03/25/2021] [Indexed: 02/05/2023]
Abstract
The Transplant Centers belonging to Gruppo Italiano per il Trapianto di Midollo Osseo (GITMO) conducted a survey with the aim of evaluating the effect of SARS-CoV2 pandemic on the allogeneic transplant activity in Italy. The pandemic period from 1/3/2020 to 31/7/2020 was compared with the same period in 2019. Overall, in 2020 there was a 2.4% reduction in the number of allo-HCT cases compared to 2019. Interestingly, this deflection did not affect the acute leukemia cases (+5.7% in 2020). The use of peripheral blood-derived stem cells (+10.7%) and cryopreservation (97.4% of the centers) was highly adopted in 2020. Despite the sanitary emergency, almost all of the surveyed centers declared no impact of SARS-CoV2 pandemic on the transplant timing and outcomes, and the sanitary policy was positively evaluated by the majority of centers. The emergency measures ensured that only a minority of the allo-HCT patients had been infected by SARS-CoV2; however, a mortality of 42.1% among the allo-HCT patients hospitalized for COVID-19 was recorded. This survey gives us the information that the GITMO Group reacted positively to the pandemic. Thanks to the emergency strategies, the Italian allo-HCT activity continued safely, showing only a minor deflection and offering the same probability of cure to the transplanted patients.
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Affiliation(s)
- Domenico Russo
- grid.7637.50000000417571846Unit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Nicola Polverelli
- grid.7637.50000000417571846Unit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Michele Malagola
- grid.7637.50000000417571846Unit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Mirko Farina
- grid.7637.50000000417571846Unit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Alessandro Leoni
- grid.7637.50000000417571846Unit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Simona Bernardi
- grid.7637.50000000417571846Unit of Blood Diseases and Bone Marrow Transplantation, Cell Therapies and Hematology Research Program, Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy ,grid.412725.7Centro di Ricerca Emato-Oncologica AIL (CREA), ASST Spedali Civili di Brescia, Brescia, Italy
| | | | - Nicoletta Sacchi
- grid.450697.90000 0004 1757 8650Italian Bone Marrow Donor Registry, Galliera Hospital, Genova, Italy
| | - Massimo Martino
- Stem Cell Transplant Program, Clinical Section, Department of Hemato-Oncology and radiotherapy, Grande Ospedale Metropolitano “Bianchi-Melacrino-Morelli”, Reggio Calabria, Italy
| | - Fabio Ciceri
- grid.18887.3e0000000417581884San Raffaele Scientific Institute, Milan, Italy
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