Hematopoietic Stem Cell Transplantation Strategies Amid COVID-19: Seattle Experience

Overview

The Blood and Marrow Transplant Program at Fred Hutchinson Cancer Research Center rapidly adapted to the COVID-19 pandemic by implementing infection control measures, deferring nonurgent transplants, and expanding telehealth services. These strategies enabled continued care delivery despite resource constraints and high local COVID-19 burden.

Background

The first confirmed COVID-19 case in the USA was reported in Washington state in January 2020, with King County becoming a major hotspot. The Fred Hutchinson Cancer Research Center, located in this epicenter, faced challenges in maintaining hematopoietic stem cell transplantation (HSCT) services amid rising cases and resource shortages. Early in the pandemic, the center coordinated closely with partner institutions to implement infection prevention and operational changes to protect patients and staff. These efforts included SARS-CoV-2 testing, visitor restrictions, and telehealth adoption to mitigate transmission risks.

Data Highlights

Key Findings

• Early implementation of SARS-CoV-2 PCR testing for all transplant patients to identify asymptomatic carriers and reduce transmission risk.
• Deferral of nonurgent transplants and postponement of referrals from outside the immediate region to prioritize urgent cases.
• Adoption of telehealth consultations to maintain patient communication while minimizing exposure.
• Institution-wide infection prevention measures including symptom screening, work-from-home mandates, and visitor restrictions.
• Expansion of negative pressure rooms on the inpatient BMT unit to prepare for COVID-19-positive transplant patients.
• Redeployment of outpatient transplant nurses to COVID-19 screening and triage roles to support institutional needs.

Clinical Implications

HSCT programs in COVID-19 hotspots should implement comprehensive infection control protocols including pretransplant testing and visitor limitations. Telehealth can effectively maintain patient-provider communication while reducing exposure risk. Preparing infrastructure such as negative pressure rooms and flexible staffing models is critical to sustain transplant services during pandemic surges.

Conclusion

The Fred Hutchinson Cancer Research Center’s proactive and multifaceted response enabled continued hematopoietic stem cell transplantation care during the COVID-19 pandemic’s initial surge. Their experience offers valuable insights for transplant centers navigating ongoing and future pandemic challenges.

References

1. Washington State Department of Health 2020 -- COVID-19 Data Dashboard
2. Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance 2020 -- Hematopoietic Stem Cell Transplantation Strategies in Response to the COVID-19 Pandemic