CT-107: Coronavirus Disease in Bone Marrow Transplant (BMT) Recipients at Edgardo Rebagliati Martins Hospital (HNERM) Lima, Peru

• Published in: Clinical lymphoma, myeloma and leukemia myeloma and leukemia, 2021-09, Vol.21, p.S449-S449
• Main Authors: Bazan, Susy, Rodriguez, Ruben, Espinioza, Vladimir, Wong, Alfredo, Morales-Coloma, Melissa, Navarro, Juan, Aranda, Lourdes
• Format: Article
• Language: English
• Subjects: BMT; cancer; Cellular Therapy; COVID-19; immunosuppressed; mortality
• ISSN: 2152-2650; 2152-2669
• DOI: 10.1016/S2152-2650(21)01997-2

SARS-CoV-2 and the COVID-19 pandemic have changed hematopoietic stem cell transplantation and medical practices worldwide. This is a single-institution cohort of 221 bone marrow recipients at HNERM in Lima, Peru. Patients were transplanted from January 2019 to December 2020. All were maintained under close SARS-CoV-2 vigilance and were followed up until April 2021.We excluded patients who had coronavirus disease prior to transplant. Among patients, 23 (10.4%) developed COVID-19. The detection of the virus based on PCR from nasopharyngeal swabs performed at the presentation of symptoms (fever, cough, and dyspnea) or if clinical/familiar/close contacts with COVID-19 was reported. We analyzed 109 (49.3%) autologous and 66 (29.8%) fully matched related allografts with methotrexate and cyclosporine as GVHD profilaxis and 46 (20.8%) haploidentical allografts with post-transplant cyclophospamide (PTCy). Median age for positive cases was 43.2 years (range 8.7–71.9). M/F ratio was 2/1. Median age for negative cases was 39.4 years (range 3.2–70.3). The median Hematopoietic Comorbidity Index (HCT-CI) score was 1.04 (range 0–5) for SARS-CoV-2-positive cases. COVID-19 disease was more often observed among haplo-identical (7/46, 15.2%), auto-BMT (12/109; 11%) and fully matched related allografts (4/66; 6.06%). Median time from BMT to positive SARS-CoV-2 PCR was 13.3 months (range 5.5–24.5). Six cases each (26%) were multiple myeloma (MM) and lymphoma (L), 5 cases were ALL (21.7%), 4 cases were AML (17.4%), and 1 case each (4.35%) was MDS and autoimmune disease. Most patients developed mild COVID-19 (n=19; 82.6%), with cough, fatigue, and myalgia as frequent symptoms. Severe COVID-19 developed in 4 cases (17.4%) requiring mechanical ventilation, 2 of whom died. Both of the lethal cases were middle-aged men who received auto-BMT for MM and L at 18.57 and 2.43 months after transplant. The HCT-CI scores were 3 and 1. The mortality rate for SARS-CoV-2 positive patients was 8.7%, much higher than among the general population in Peru (2.84%), but less than in HNERM (46.4%). Our cohort showed COVID-19 disease in BMT patients is more frequent in men, similar to the general population. Most of the cases were observed for auto-BMT, specifically among MM and L patients, with similar frequency for both.