In a study, a research group led by Halle University Medicine analyzed the risk factors, the course of the disease and the consequences of contracting COVID-19 in patients after allogeneic stem cell transplantation.
In allogeneic stem cell transplants, patients who suffer from hemato-oncological diseases, i.e. diseases of the blood-forming system, receive stem cells from a stranger. The patient's immune system is reduced to an absolute minimum and the body is correspondingly weakened and vulnerable after the transplant.
“Our retrospective, multicenter study commissioned by the German Cooperative Transplantation Study Group included patients after allogeneic stem cell transplantation who were infected with SARS-CoV-2 between February 2020 and July 2021 - that is, before the vaccines were available. The classification of the severity into mild, moderate and critical COVID-19 illnesses as well as the division of the course of the pandemic into four phases was based on recommendations from the Robert Koch Institute.”
apl. Prof. Dr. Lutz Müller, head of the clinical transplantation area at the University Hospital and Polyclinic for Internal Medicine IV (KIM IV) of the University Medical Center Halle
“We found that patients after allogeneic stem cell transplantation have a significantly increased risk of death after infection with SARS-CoV-2 compared to infected people in the normal population.”
Dr. Judith Schaffrath, first author of the study and specialist at KIM IV
By July 2021, 130 patients from 14 German and Austrian transplant centers with a median age of 59 years at infection with SARS-CoV-2 and a median time between allogeneic stem cell transplant and COVID-19 of 787 days were included in the study. The most common underlying diseases were acute myeloid leukemia (AML; 45.4 percent) and lymphoma (10.8 percent). The majority of patients (84.9 percent) became infected with SARS-CoV-2 in the later phases of the pandemic, i.e. in the 2nd and 3rd waves. Around 21 percent of the patients developed moderately severe COVID-19 disease, a good twelve percent were critically ill; Almost a fifth were treated in an intensive care unit.
“Unfortunately, one in two died, especially among those patients who were so seriously ill with COVID-19 that they had to be treated in the intensive care unit. Looking across all patient groups, the mortality rate was 16.2 percent.”
Dr. Judith Schaffrath, first author of the study and specialist at KIM IV
Risk factors included active underlying disease, infection with SARS-CoV-2 within 365 days of allogeneic stem cell transplantation, age over 60 years, and ongoing immunosuppression. Risk factors for developing moderate or critical illness were concurrent immunosuppression and age over 40 years.
“Based on these data and findings, we at Halle University Medicine have determined that these patients, especially as long as the pandemic situation continues, will continue to be classified as a high-risk group and will receive special care to protect them from SARS-CoV-2 infection. To protect against infection and recommend this accordingly.”
apl. Prof. Lutz Müller
Further studies are also needed to identify the best treatment and vaccination options for these patients.
Source: German health portal
Original publication:
Judith Schaffrath, Christina Brummer, Daniel Wolff, Udo Holtick, Nicolaus Kröger, Martin Bornhäuser, Sabrina Kraus, Inken Hilgendorf, Igor-Wolfgang Blau, Olaf Penack, Christoph Wittke, Normann Steiner, David Nachbaur, Lorenz Thurner, Heidrun Hindahl, Robert Zeiser, Claus-Philipp Maier, Wolfgang Bethge, Lutz P. Müller,
High Mortality of COVID-19 Early after Allogeneic Stem Cell Transplantation: A Retrospective Multicenter Analysis on Behalf of the German Cooperative Transplant Study Group, Transplantation and Cellular Therapy, 2022.
https ://doi.org/10.1016/j.jtct.2022.03.010
Further information:
https://www.medizin.uni-halle.de/presse
https://www.medizin.uni-halle.de/kim4
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