[Allogeneic hematopoietic stem cell transplantation during the normalization stage of COVID-19 management]

Area of Science:

• Hematology
• Infectious Diseases
• Transplantation Medicine

Context:

• The COVID-19 pandemic has entered a phase of normalized management, yet it continues to impact patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT).
• Understanding the implications of SARS-CoV-2 infection on HSCT strategies and patient outcomes is crucial during this ongoing public health challenge.

Purpose:

• To review and discuss the potential effects of COVID-19 on allogeneic hematopoietic stem cell transplantation (allo-HSCT) strategies and patient prognosis.
• To provide guidance on managing SARS-CoV-2 infection in the context of allo-HSCT based on current literature.

Summary:

• For patients infected with SARS-CoV-2 before transplantation, deferring the procedure until clinical resolution and negative tests is advised.
• While SARS-CoV-2 infection in stem cell donors during collection may not impede apheresis, recipients experiencing COVID-19 early post-transplantation face a high risk of severe illness.
• Severe COVID-19 is identified as a significant risk factor impacting both non-relapse mortality and overall survival following allo-HSCT.

Impact:

• Highlights the critical need for careful timing of allo-HSCT in relation to SARS-CoV-2 infection.
• Emphasizes that severe COVID-19 adversely affects survival outcomes in allo-HSCT recipients.
• Underscores the necessity for further large-scale studies to elucidate the relationship between COVID-19 and post-transplantation complications, including infections and relapse.