Allogeneic hematopoietic cell transplantation after infection with SARS-CoV-2 during the COVID-19 pandemic: a multicenter retrospective analysis - Scorecard - MDSpire
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Allogeneic hematopoietic cell transplantation after infection with SARS-CoV-2 during the COVID-19 pandemic: a multicenter retrospective analysis
Clinical Scorecard: Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation Following SARS-CoV-2 Infection During the COVID-19 Pandemic: A Multicenter Retrospective Study
At a Glance
Category
Detail
Condition
Allogeneic hematopoietic stem cell transplantation (alloHCT) in patients with prior SARS-CoV-2 infection
Key Mechanisms
Impact of COVID-19 severity and pre-transplant functional status on transplant outcomes including non-relapse mortality and overall survival
Target Population
Patients undergoing alloHCT with prior SARS-CoV-2 infection
Care Setting
Multicenter transplant centers in Germany and Austria during the COVID-19 pandemic
Key Highlights
COVID-19 severity prior to alloHCT significantly affects 1-year overall survival and non-relapse mortality.
Patients with mild COVID-19 and high Karnofsky Index (90–100) have the best post-transplant outcomes.
No significant association found between COVID-19 severity and incidence of Graft-versus-Host Disease.
Guideline-Based Recommendations
Diagnosis
Classify COVID-19 severity using WHO criteria prior to alloHCT.
Assess pre-transplant pulmonary function (FEV1, FEV1/FVC) and functional status (Karnofsky Index).
Management
Delay alloHCT until patients test negative for SARS-CoV-2 at conditioning start.
Prioritize preventive measures including vaccination and antiviral therapies to reduce severe COVID-19 cases.
Implement tailored pre-transplant assessments focusing on functional status.
Monitoring & Follow-up
Monitor for relapse and non-relapse mortality up to 365 days post-transplant.
Evaluate functional status and pulmonary function as predictors of transplant outcomes.
Risks
Severe/critical COVID-19 prior to alloHCT increases risk of death and non-relapse mortality.
Lower Karnofsky Index (<90) is associated with worse disease-free and overall survival.
Patient & Prescribing Data
75 patients with prior SARS-CoV-2 infection undergoing alloHCT
Patients with mild COVID-19 and good functional status have favorable outcomes; severe COVID-19 correlates with higher mortality, emphasizing the need for individualized timing and preventive strategies.
Clinical Best Practices
Use WHO COVID-19 severity classification to stratify risk before alloHCT.
Incorporate Karnofsky Index assessment into pre-transplant evaluation.
Ensure patients are SARS-CoV-2 negative at conditioning initiation.
Maintain infection control measures and vaccination to minimize severe COVID-19 incidence.
Consider delaying alloHCT in patients with severe/critical COVID-19 to improve outcomes.
by Osama Ahmad, Nicolaus Kröger, Eva Wagner-Drouet, David Nachbaur, Normann Steiner, Daniel Teschner, Sabrina Kraus, Gesine Bug, Salem Ajib, Johannes Schetelig, Wolfgang Andreas Bethge, Thomas Schroeder, Judith Schaffrath, Lutz Peter Müller, Mareike Verbeek, Edgar Jost, Hatice Soysal, Johanna Tischer, Georg-Nikolaus Franke, Stefan Klein, Udo Holtick, Knut Wendelin, Claudia Lengerke, Martin Bornhäuser, Jan Frederic Weller, Maximilian Christopeit
