Cellular Therapy During COVID-19: Lessons Learned and Preparing for Subsequent Waves.

Autor: Nawas MT; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York., Shah GL; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Medicine, Weill Cornell Medical College, New York, New York., Feldman DR; Department of Medicine, Weill Cornell Medical College, New York, New York.; Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York., Ruiz JD; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York., Robilotti EV; Department of Medicine, Weill Cornell Medical College, New York, New York.; Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Infection Control, Memorial Sloan Kettering Cancer Center, New York, New York., Aslam AA; Infection Control, Memorial Sloan Kettering Cancer Center, New York, New York., Dundas M; Infection Control, Memorial Sloan Kettering Cancer Center, New York, New York., Kamboj M; Department of Medicine, Weill Cornell Medical College, New York, New York.; Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Infection Control, Memorial Sloan Kettering Cancer Center, New York, New York., Barker JN; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Medicine, Weill Cornell Medical College, New York, New York., Cho C; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Medicine, Weill Cornell Medical College, New York, New York., Chung DJ; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Medicine, Weill Cornell Medical College, New York, New York., Dahi PB; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Medicine, Weill Cornell Medical College, New York, New York., Giralt SA; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Medicine, Weill Cornell Medical College, New York, New York., Gyurkocza B; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Medicine, Weill Cornell Medical College, New York, New York., Lahoud OB; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Medicine, Weill Cornell Medical College, New York, New York., Landau HJ; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Medicine, Weill Cornell Medical College, New York, New York., Lin RJ; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Medicine, Weill Cornell Medical College, New York, New York., Mailankody S; Department of Medicine, Weill Cornell Medical College, New York, New York.; Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York., Palomba ML; Department of Medicine, Weill Cornell Medical College, New York, New York.; Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York., Papadopoulos EB; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Medicine, Weill Cornell Medical College, New York, New York., Politikos I; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Medicine, Weill Cornell Medical College, New York, New York., Ponce DM; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Medicine, Weill Cornell Medical College, New York, New York., Sauter CS; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Medicine, Weill Cornell Medical College, New York, New York., Shaffer BC; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Medicine, Weill Cornell Medical College, New York, New York., Scordo M; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Medicine, Weill Cornell Medical College, New York, New York., van den Brink MRM; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Medicine, Weill Cornell Medical College, New York, New York., Perales MA; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Medicine, Weill Cornell Medical College, New York, New York., Tamari R; Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Medicine, Weill Cornell Medical College, New York, New York.
Jazyk: angličtina
Zdroj: Transplantation and cellular therapy [Transplant Cell Ther] 2021 May; Vol. 27 (5), pp. 438.e1-438.e6. Date of Electronic Publication: 2021 Feb 14.
DOI: 10.1016/j.jtct.2021.02.011
Abstrakt: 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. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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