Synapse - Cellular therapy during COVID-19: Lessons learned and preparing for subsequent waves

Cellular therapy during COVID-19: Lessons learned and preparing for subsequent waves Journal Article

Authors:	Nawas, M. T.; Shah, G. L.; Feldman, D. R.; Ruiz, J. D.; Robilotti, E. V.; Aslam, A. A.; Dundas, M.; Kamboj, M.; Barker, J. N.; Cho, C.; Chung, D. J.; Dahi, P. B.; Giralt, S. A.; Gyurkocza, B.; Lahoud, O. B.; Landau, H. J.; Lin, R. J.; Mailankody, S.; Palomba, M. L.; Papadopoulos, E. B.; Politikos, I.; Ponce, D. M.; Sauter, C. S.; Shaffer, B. C.; Scordo, M.; van den Brink, M. R. M.; Perales, M. A.; Tamari, R.
Article Title:	Cellular therapy during COVID-19: Lessons learned and preparing for subsequent waves
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. © 2021 The American Society for Transplantation and Cellular Therapy
Keywords:	hematopoietic cell transplantation; cellular therapy; chimeric antigen receptor t cell therapy; covid-19
Journal Title:	Transplantation and Cellular Therapy
Volume:	27
Issue:	5
ISSN:	2666-6375
Publisher:	Elsevier Inc.
Date Published:	2021-05-01
Start Page:	438.e1
End Page:	438.e6
Language:	English
DOI:	10.1016/j.jtct.2021.02.011
PROVIDER:	scopus
PMCID:	PMC7952254
PUBMED:	33728417
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85103115027&doi=10.1016%2fj.jtct.2021.02.011&partnerID=40&md5=4062d0857c95c2f0b7632195e4fb8494
Notes:	Article -- Export Date: 1 June 2021 -- Source: Scopus