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COVID-19 omicron variant outbreak in a hematopoietic stem cell transplant unit

by Bresciani, Paola , Forghieri, Fabio , Pecorari, Monica , Giusti, Davide , Franceschini, Erica , Bettelli, Francesca , Morselli, Monica , Gennari, William , Candoni, Anna , Trenti, Tommaso , Comoli, Patrizia , Pioli, Valeria , Potenza, Leonardo , Marasca, Roberto , Messerotti, Andrea , Colasante, Corrado , Gilioli, Andrea , Luppi, Mario , Colaci, Elisabetta , Cuoghi, Angela , Mussini, Cristina

in Antiviral agents / Antiviral drugs / Blood cancer / Blood diseases / Bone marrow / Bone marrow transplantation / Case Report / COVID-19 / Health risks / Hematological diseases / Hematology / Hematopoietic stem cells / Immunosuppressive agents / Infections / Malignancy / Medicine / Medicine & Public Health / Monoclonal antibodies / Oncology / Outbreaks / Pandemics / Severe acute respiratory syndrome coronavirus 2 / Stem cell transplantation / Stem cells / Transplantation / Vaccines / Viral diseases

2023

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COVID-19 omicron variant outbreak in a hematopoietic stem cell transplant unit

2023

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COVID-19 omicron variant outbreak in a hematopoietic stem cell transplant unit

2023

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Journal Article

COVID-19 omicron variant outbreak in a hematopoietic stem cell transplant unit

Bresciani, Paola,

Forghieri, Fabio,

Pecorari, Monica,

Giusti, Davide,

Franceschini, Erica,

Bettelli, Francesca,

Morselli, Monica,

Gennari, William,

Candoni, Anna,

Trenti, Tommaso,

Comoli, Patrizia,

Pioli, Valeria,

Potenza, Leonardo,

Marasca, Roberto,

Messerotti, Andrea,

Colasante, Corrado,

Gilioli, Andrea,

Luppi, Mario,

Colaci, Elisabetta,

Cuoghi, Angela,

Mussini, Cristina

2023

Overview

Recommendations and guidelines for management of SARS-COV-2 infection in hematologic patients were developed in the very difficult context of dealing with novel viral variants from one pandemic wave to another, with different susceptibility to available drugs and vaccines. Moreover, the largest SARS-COV-2 case series in patients treated for hematologic malignancies, including stem cell transplant recipients, was published before the Omicron surge, and refers mainly to Alpha and Delta viral variants. These infections had very high mortality, in a period when antivirals and monoclonal antibodies were mostly unavailable. Here, we report for the first time a SARS-COV-2 Omicron variant outbreak inside a Bone Marrow Transplant (BMT) Unit, describing the characteristics, clinical course, and infection outcomes shortly before and shortly after myeloablative transplantation. We detail how infections were treated off-label and managed inside the BMT ward, to guarantee the best possible outcomes while avoiding risks for non-infected inpatients. The positive outcomes observed suggest that it may not be absolutely necessary to obtain SARS-CoV-2 PCR negativity before BMT in hematologic patients after treated infection, in cases with long-term PCR positivity and high-risk hematologic disease.

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Publisher

Springer Nature Singapore,Springer Nature B.V

Subject

/ Bone marrow transplantation

/ Case Report