How I treat and prevent COVID-19 in patients with hematologic malignancies and recipients of cellular therapies

• Published in: Blood 2022-08, Vol.140 (7), p.673-684
• Main Authors: El Chaer, Firas, Auletta, Jeffery J., Chemaly, Roy F.
• Format: Article
• Language: English
• Subjects: Adult; Cell- and Tissue-Based Therapy; COVID-19 - complications; COVID-19 Vaccines; Hematologic Neoplasms - complications; Hematologic Neoplasms - therapy; How I Treat; Humans; SARS-CoV-2
• ISSN: 0006-4971; 1528-0020; 1528-0020
• DOI: 10.1182/blood.2022016089

Patients with hematologic malignancies and recipients of hematopoietic cell transplantation (HCT) are more likely to experience severe coronavirus disease 2019 (COVID-19) and have a higher risk of morbidity and mortality after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Compared with the general population, these patients have suboptimal humoral responses to COVID-19 vaccines and subsequently increased risk for breakthrough infections, underscoring the need for additional therapies, including pre- and postexposure prophylaxis, to attenuate clinical progression to severe COVID-19. Therapies for COVID-19 are mostly available for adults and in the inpatient and outpatient settings. Selection and administration of the best treatment options are based on host factors; virus factors, including circulating SARS-CoV-2 variants; and therapeutic considerations, including the clinical efficacy, availability, and practicality of treatment and its associated side effects, including drug-drug interactions. In this paper, we discuss how we approach managing COVID-19 in patients with hematologic malignancies and recipients of HCT and cell therapy. [Display omitted]