COVID-19 systematic screening of asymptomatic haematopoietic stem cell donors: Less if often more

Area of Science:

• Hematology
• Infectious Diseases
• Transplantation Immunology

Background:

• Hematopoietic stem cell transplantation (HSCT) relies on donor registries for patient treatment.
• The COVID-19 pandemic prompted many registries to implement routine pre-collection COVID-19 testing for all donors.
• The scientific basis for systematic COVID-19 testing of all HSCT donors is not well-established in existing literature.

Observation:

• A case of sibling allogeneic HSCT proceeded despite the related donor being asymptomatic but testing positive for COVID-19.
• A review of seven reported cases involving HSCT with COVID-19 positive donors was conducted.
• Current practices lack systematic COVID-19 testing for other blood products used in treating hematological malignancies.

Findings:

• Routine, systematic COVID-19 testing for all unrelated HSCT donors may not be necessary.
• Proceeding with HSCT from asymptomatic, COVID-19 positive donors is feasible, as demonstrated by case reports.
• The lack of parallel systematic COVID-19 screening for other transfused blood products highlights potential inconsistencies in donor screening protocols.

Implications:

• Re-evaluation of current guidelines for systematic COVID-19 donor screening in HSCT is warranted.
• This could lead to more nuanced and evidence-based donor selection protocols, potentially reducing unnecessary testing burdens.
• Optimizing donor screening strategies is crucial for maintaining HSCT program efficiency and patient safety while adapting to evolving infectious disease landscapes.