key: cord-0732746-30cxm393
authors: Sharma, Akshay; Bhatt, Neel S.; Martin, Andrew St.; Abid, Muhammad Bilal; Bloomquist, Jenni; Chemaly, Roy F.; Dandoy, Christopher E.; Gauthier, Jordan; Gowda, Lohith; Perales, Miguel A.; Seropian, Stuart E.; Shaw, Bronwen E.; Tuschl, Eileen E.; Zeidan, Amer; Riches, Marcie L.; Shah, Gunjan L.
title: 5 COVID-19 in Hematopoietic Cell Transplant Recipients: A CIBMTR Study
date: 2021-03-31
journal: Transplantation and Cellular Therapy
DOI: 10.1016/s2666-6367(21)00031-2
sha: 200dcb9899e40d757de80a45034d28ed3c7dc170
doc_id: 732746
cord_uid: 30cxm393

nan

Akshay Sharma, MBBS 1 , Neel S. Bhatt, MBBS, MPH 2 , Andrew St. Martin, MS 3 , Muhammad Bilal Abid, MD, MRCP 4 , Jenni Bloomquist, MS 5 , Roy F. Chemaly, MD, MPH, FIDSA, FACP 6 , Christopher E. Dandoy, MD, MS 7 , Jordan Gauthier, MD, MSc 8 , Lohith Gowda, MD, MRCP 9 , Miguel A. Perales, MD 10 , Stuart E. Seropian, MD 9 , Bronwen E. Shaw, MD, PhD 11 , Eileen E. Tuschl, DNP, RN, APNP 11 , Amer Zeidan, MBBS, MHS 12 , Marcie L. Riches, MD, MS 13 , Gunjan L. Shah, MD 14 various factors associated with mortality following COVID-19 diagnosis for recipients of allogeneic HCT (alloHCT) and autologous HCT (autoHCT). Results: Characteristics of the patients included in the study are reported in Table 1 . Disease severity was mild in 49%, and severe (requiring mechanical ventilation) in 14% of patients. The overall probability of survival was 68% at 30 days after COVID-19 diagnosis (Fig. 1) . Age over 50 years, male gender and development of COVID-19 within 12 months of HCT were associated with a higher risk of mortality among alloHCT recipients (Fig. 2) . For the recipients of autoHCT, diagnosis of lymphoma (compared to plasma cell disorders) was associated with higher mortality (Fig. 3) . Absolute lymphocyte count ≤0.3×10 9 /L at COVID-19 diagnosis was associated with worse survival (p=0.003).

Conclusions: This report is the largest series to date summarizing the outcomes of HCT recipients with COVID-19. Among recipients of alloHCT with COVID-19, older age, male gender and development of COVID-19 within 12 months of transplant were risk factors for increased mortality. 

NCI R01 CA181050) hypothesized 80% PFS at 12 months for children with CR1&2 ALL/CR1&2 AML/MDS undergoing HCT using KIR-favorable haploidentical donors (favorable B content and/or ligand mismatch) that were abCD3/CD19 depleted. The study was open at 11 centers and enrolled 52 patients on the phase II portion of the trial between 4/2016 and 5/2020. Four regimens were allowed including myeloablative (MA, rATG/TBI/ thio/cy or rATG/bu/thio/cy) and reduced toxicity (RTC, rATG/ mel/thio/flu or TLI/flu/cy/thio/mel) options. Median recipient and donor ages were

Results: Cumulative incidence (CI) of grade II-III aGVHD at 100d was 12% (95% CI; 3-20%), CI of cGVHD at 2 yrs was 8% (0-16%). Rejection and NRM were low at 6.8% and 9.6%, respectively. At 1 and 2 years

Donor age and sex did not affect outcomes, but CMV positive status was associated with an increased risk of grades 2-3 aGVHD (p=0.026). Flow MRD status <0.01% prior to HCT was associated with superior OS (83 vs. 33%; p= 0.007), DFS (78 vs. 33%; p=0.001) and EFS (74 vs. 17%; p=0.001) as well as a marked decrease in risk of relapse (p= 0.001; Fig. 2). The use of RTC was associated with improved OS at 2 years (91 vs. 59%

32) compared to MA regimens. Conclusions: This prospective multi-center trial showed that abCD3/CD19 depleted haplo HCT using KIR favorable donors resulted in exceptional