Blood Res.  2023 Mar;58(1):13-19. 10.5045/br.2023.2022144.

The impact of COVID-19 on acute myeloid leukemia patients undergoing allogeneic stem cell transplantation: a concise review

• Mansour RO
• El-Ashwah S
• Denewer M

• KMID: 2541060
• DOI: http://doi.org/10.5045/br.2023.2022144

Abstract

This study aimed to delineate the possible impact of COVID-19 on acute myeloid leukemia (AML) patients in terms of diagnosis, chemotherapy, bone marrow transplant, and vaccination response. Allogeneic stem cell transplantation is markedly affected by the COVID-19 pandemic, as both donors and recipients must be healthy for transplantation to be feasible and successful. Delays in the identification of well-matched donors have been predicted, and represent a special challenge. Therefore, future donors should be tested for COVID-19. The outcome of delayed transplantation is vague and masked by variations in stem cell source along with disease subtype. However, if transplant delay results in recurrence of minimal residual disease, a negative impact on survival is anticipated.

Keyword

Allogeneic-stem cell transplantation; Acute myeloid leukemia; COVID-19; SARS-CoV-2

Figure

• 

  Fig. 1 Assessment of lymphocyte subsets over time before, during, and in recovery from COVID-19 in allogeneic-SCT recipients [3].

• 

  Fig. 2 Assessment of allogeneic-SCT during COVID-19 [12].

• 

  Fig. 3 Infection prevention approach for bone marrow transplant units during COVID-19 [12].

• 

  Fig. 4 Outcomes of allogeneic-SCT recipients with either fresh or cryopreserved grafts [13].

• 

  Fig. 5 Relationship between antibody titer after COVID-19 vaccination and time after allogeneic-SCT with post-transplantation cyclophos-phamide conditioning. Vaccination titer in AU/mL [14].

Reference

1. Shah N, Dahi PB, Ponce DM, et al. 2022; Hematopoietic cell trans-plantation is feasible in patients with prior COVID-19 infection. Transplant Cell Ther. 28:55e1–5. DOI: 10.1016/j.jtct.2021.10.004. PMID: 34649021. PMCID: PMC8503970.

2. Di Cristanziano V, Meyer-Schwickerath C, Eberhardt KA, et al. 2021; Detection of SARS-CoV-2 viremia before onset of COVID-19 symptoms in an allo-transplanted patient with acute leukemia. Bone Marrow Transplant. 56:716–9. DOI: 10.1038/s41409-020-01059-y. PMID: 32943755.

3. Shah GL, DeWolf S, Lee YJ, et al. 2020; Favorable outcomes of COVID-19 in recipients of hematopoietic cell transplantation. J Clin Invest. 130:6656–67. DOI: 10.1172/JCI141777. PMID: 32897885. PMCID: PMC7685738.

4. Schaffrath J, Brummer C, Wolff D, et al. 2022; High mortality of COVID-19 early after allogeneic stem cell transplantation: a retrospective multicenter analysis on behalf of the German Cooperative Transplant Study Group. Transplant Cell Ther. 28:337e1–10. DOI: 10.1016/j.jtct.2022.03.010. PMID: 35296445. PMCID: PMC8918088.

5. Greiner J, Götz M, Malner-Wagner W, et al. 2021; Characteristics and mechanisms to control a COVID‐19 outbreak on a leukemia and stem cell transplantation unit. Cancer Med. 10:237–46. DOI: 10.1002/cam4.3612. PMID: 33314627. PMCID: PMC7826490.

6. Gavillet M, Carr Klappert J, Spertini O, Blum S. 2020; Acute leukemia in the time of COVID-19. Leuk Res. 92:106353. DOI: 10.1016/j.leukres.2020.106353. PMID: 32251934. PMCID: PMC7138175.

7. Raza A, Assal A, Ali AM, Jurcic JG. 2020; Rewriting the rules for care of MDS and AML patients in the time of COVID-19. Leuk Res Rep. 13:100201. DOI: 10.1016/j.lrr.2020.100201. PMID: 32318330. PMCID: PMC7169905.

8. Brissot E, Labopin M, Baron F, et al. 2021; Management of patients with acute leukemia during the COVID-19 outbreak: practical guidelines from the acute leukemia working party of the European Society for Blood and Marrow Transplantation. Bone Marrow Transplant. 56:532–5. DOI: 10.1038/s41409-020-0970-x. PMID: 32528122. PMCID: PMC7289070.

9. Leclerc M, Fourati S, Menouche D, Challine D, Maury S. 2021; Allogeneic haematopoietic stem cell transplantation from SARS-CoV-2 positive donors. Lancet Haematol. 8:e167–9. DOI: 10.1016/S2352-3026(21)00025-9. PMID: 33539769. PMCID: PMC7906696.

10. Christopeit M, Reichard M, Niederwieser C, et al. 2021; Allogeneic stem cell transplantation in acute leukemia patients after COVID-19 infection. Bone Marrow Transplant. 56:1478–81. DOI: 10.1038/s41409-021-01225-w. PMID: 33564122. PMCID: PMC7871512.

11. Maurer K, Saucier A, Kim HT, et al. 2021; COVID-19 and hematopoietic stem cell transplantation and immune effector cell therapy: a US cancer center experience. Blood Adv. 5:861–71. DOI: 10.1182/bloodadvances.2020003883. PMID: 33560397. PMCID: PMC7869610.

12. Waghmare A, Abidi MZ, Boeckh M, et al. 2020; Guidelines for COVID-19 management in hematopoietic cell transplantation and cellular therapy recipients. Biol Blood Marrow Transplant. 26:1983–94. DOI: 10.1016/j.bbmt.2020.07.027. PMID: 32736007. PMCID: PMC7386267.

13. Hamadani M, Zhang MJ, Tang XY, et al. 2020; Graft cryopreservation does not impact overall survival after allogeneic hematopoietic cell transplantation using post-transplantation cyclophosphamide for graft-versus-host disease prophylaxis. Biol Blood Marrow Transplant. 26:1312–7. DOI: 10.1016/j.bbmt.2020.04.001. PMID: 32283185. PMCID: PMC7194895.

14. Morsink LM, van Doesum J, Choi G, et al. 2022; Robust COVID-19 vaccination response after allogeneic stem cell transplantation using post transplantation cyclophosphamide conditioning. Blood Cancer J. 12:6. DOI: 10.1038/s41408-021-00605-1. PMID: 35022420. PMCID: PMC8754065. PMID: a194596df02245308c9774ef6b8c0022.