Hemato-oncology unit, Internal Medicine Department, An-Najah National University Hospital, An-Najah National University, Nablus, Palestine.
Internal Medicine Department, An-Najah National University Hospital, Nablus, Palestine.
Transplant Proc. 2023 Apr;55(3):543-546. doi: 10.1016/j.transproceed.2023.02.032. Epub 2023 Feb 27.
Patients with hematologic malignancies are considered at high risk for COVID-19 infection either from the disease or the treatment. Hematopoietic stem cell transplantation, one of the approved therapies for hematologic malignancies, was performed worldwide during the COVID-19 era with some regulations, such as COVID-19 testing, before proceeding with transplantation or cellular therapy. To the authors' knowledge, none have reported the result of autologous hematopoietic stem cell transplantation in an active COVID-19 patient.
We describe a successful clinical course of autologous bone marrow transplantation for 2 lymphoma patients who tested positive for COVID-19. A thorough discussion was conducted between multidisciplinary hemato-oncology, intensive care, and infectious diseases teams. The decision was to proceed toward bone marrow transplantation with some modifications in the transplantation protocol and close patient monitoring.
Our cases lend credence that successful autologous bone marrow transplantation is possible among active COVID-19 patients. The obstacles we faced could be overcome with collaboration between a highly qualified multidisciplinary team. Despite the potential complications, the benefits of bone marrow transplantation among patients with a high risk of relapse and who are still COVID-19-positive outweigh the risks. However, further studies are still recommended to support our inference.
患有血液系统恶性肿瘤的患者,无论是由于疾病本身还是治疗原因,都被认为具有较高的 COVID-19 感染风险。造血干细胞移植是血液系统恶性肿瘤的一种已批准的治疗方法,在 COVID-19 期间,全球范围内都在进行该治疗,并且在进行移植或细胞治疗前,有一些规定,如 COVID-19 检测。据作者所知,尚无关于在 COVID-19 活跃期患者中进行自体造血干细胞移植的结果的报道。
我们描述了 2 例淋巴瘤患者在 COVID-19 检测呈阳性后成功进行自体骨髓移植的临床经过。多学科血液肿瘤学、重症监护和传染病团队进行了深入讨论。决定按照移植方案进行修改,并密切监测患者,继续进行骨髓移植。
我们的病例表明,在 COVID-19 活跃期患者中进行自体骨髓移植是可能的。我们所面临的障碍可以通过高素质的多学科团队的合作来克服。尽管存在潜在的并发症,但对于高复发风险且仍为 COVID-19 阳性的患者,骨髓移植的益处大于风险。但是,仍建议进行进一步的研究以支持我们的推论。