First report that prior ECMO therapy does not preclude hematopoietic cell transplantation

Area of Science:

• Hematology
• Critical Care Medicine
• Pulmonology

Background:

• Hematopoietic stem cell transplantation (HCT) is a curative option for high-risk malignancies but carries risks.
• Extracorporeal membrane oxygenation (ECMO) is often a contraindication for HCT due to concerns about lung injury and post-transplant pulmonary complications.

Observation:

• This case series examines two patients with high-risk hematologic malignancies who underwent reduced-intensity HCT after prior ECMO treatment.
• Pulmonary function recovery data after ECMO is limited, complicating pre-HCT assessments.

Findings:

• Both patients experienced post-HCT complications, but neither developed significant pulmonary toxicity attributable to their previous ECMO use.
• This suggests that prior ECMO may not preclude patients from HCT.

Implications:

• Patients with a history of ECMO should not be automatically excluded from reduced-intensity HCT consideration.
• Further research is warranted to better understand pulmonary recovery after ECMO and its impact on HCT outcomes.