Clinical Scorecard: Hematopoietic Stem Cell Transplantation Strategies in Response to the COVID-19 Pandemic: Insights from Seattle
At a Glance
Category
Detail
Condition
COVID-19 pandemic impact on hematopoietic stem cell transplantation (HSCT)
Key Mechanisms
Implementation of infection prevention, SARS-CoV-2 testing, telehealth, and operational adaptations to maintain transplant care during COVID-19 surge
Target Population
Patients requiring hematopoietic stem cell transplantation, primarily from King County and surrounding regions
Care Setting
Blood and Marrow Transplant Program at Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance and affiliated hospitals
Key Highlights
Rapid implementation of SARS-CoV-2 PCR testing for all transplant patients and symptomatic staff to identify asymptomatic carriers and reduce transmission risk.
Deferral of nonurgent procedures and transplants, and postponement of referrals from outside local counties when transplantation was less urgent.
Adoption of telehealth consultations to maintain essential communication while minimizing COVID-19 exposure.
Guideline-Based Recommendations
Diagnosis
Pretransplant SARS-CoV-2 PCR testing for all patients to identify asymptomatic infection.
Management
Defer nonurgent transplants and procedures during high COVID-19 prevalence.
Implement strict infection prevention measures including symptom screening and no-visitor policies.
Use telehealth visits for transplant consultations to reduce exposure.
Reassign high-risk clinical staff to telehealth roles to minimize their exposure.
Monitoring & Follow-up
Regular symptom screening of staff, patients, and visitors at outpatient clinics and hospitals.
Biweekly multidisciplinary COVID-19 committee meetings to review and update operational strategies.
Risks
Increased risk of transplant-related complications and mortality in asymptomatic SARS-CoV-2 carriers if not identified pretransplant.
Potential shortages of personal protective equipment, hospital beds, and clinical staff during pandemic surges.
Patient & Prescribing Data
Hematopoietic stem cell transplant candidates primarily from King County and surrounding areas during the COVID-19 pandemic.
Timely transplantation balanced against COVID-19 exposure risk; nonurgent cases deferred; telehealth used to maintain care continuity.
Clinical Best Practices
Early and comprehensive SARS-CoV-2 testing of transplant patients and symptomatic staff.
Strict infection control including work-from-home mandates for nonessential staff and no-visitor policies.
Establishment of backup clinical staffing plans to maintain service continuity.
Creation of additional negative pressure rooms for COVID-19-positive transplant patients.
Expansion of outpatient acute care services to reduce emergency room utilization.
by Masumi Ueda Oshima, Brenda M. Sandmaier, Effie Petersdorf, Mary E. Flowers, Geoffrey R. Hill, Stephanie J. Lee, Frederick R. Appelbaum, Paul A. Carpenter, K. Scott Baker, Laura Connelly-Smith, Andrea McCool, Suni Elgar, Steven A. Pergam, Catherine Liu, F. Marc Stewart, Marco Mielcarek
