TY - JOUR
T1 - Clinical Characteristics and Outcomes of COVID-19 in Pediatric and Early Adolescent and Young Adult Hematopoietic Stem Cell Transplant Recipients
T2 - A Cohort Study
AU - Bhatt, Neel S.
AU - Sharma, Akshay
AU - St. Martin, Andrew
AU - Abid, Muhammad Bilal
AU - Brown, Valerie I.
AU - Diaz Perez, Miguel Angel
AU - Frangoul, Haydar
AU - Gadalla, Shahinaz M.
AU - Herr, Megan M.
AU - Krem, Maxwell M.
AU - Lazarus, Hillard M.
AU - Martens, Michael J.
AU - Mehta, Parinda A.
AU - Nishihori, Taiga
AU - Prestidge, Tim
AU - Pulsipher, Michael A.
AU - Rangarajan, Hemalatha G.
AU - Williams, Kirsten M.
AU - Winestone, Lena E.
AU - Yin, Dwight E.
AU - Riches, Marcie L.
AU - Dandoy, Christopher E.
AU - Auletta, Jeffery J.
N1 - Funding Information:
The authors sincerely thank the Data Operations and IT groups in CIBMTR (on both the Medical College of Wisconsin and NMDP campus) for their assistance in the implementation of these data collection mechanisms. Without their dedication, the current analysis would not be possible. Financial disclosure: The CIBMTR is supported primarily by Public Health Service U24CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID), HHSH250201700006C from the Health Resources and Services Administration (HRSA), and N00014-20-1-2705 and N00014-20-1-2832 from the Office of Naval Research. Support is also provided by Be the Match Foundation, the Medical College of Wisconsin, the National Marrow Donor Program, and from the following commercial entities: AbbVie, Accenture, Actinium Pharmaceuticals, Inc. Adaptive Biotechnologies Corporation, Adienne SA; Allovir, Inc. Amgen, Inc. Astellas Pharma US, bluebird bio, inc. Bristol Myers Squibb Co. CareDx, CSL Behring, CytoSen Therapeutics, Inc. Daiichi Sankyo Co. Ltd. Eurofins Viracor, DBA Eurofins Transplant Diagnostics, Fate Therapeutics, Gamida-Cell, Ltd. Gilead, GlaxoSmithKline, HistoGenetics, Incyte Corporation, Iovance, Janssen Research & Development, LLC, Janssen/Johnson & Johnson, Jasper Therapeutics, Jazz Pharmaceuticals, Inc. Kadmon, Karius, Karyopharm Therapeutics, Kiadis Pharma, Kite Pharma Inc, Kite (a Gilead Company), Kyowa Kirin International plc, Kyowa Kirin, Legend Biotech, Magenta Therapeutics, Medac GmbH, Medexus, Merck & Co. Millennium (the Takeda Oncology Co.), Miltenyi Biotec, Inc. MorphoSys, Novartis Pharmaceuticals Corporation, Omeros Corporation, OncoImmune, Inc. Oncopeptides, Inc. OptumHealth, Orca Biosystems, Inc. Ossium Health, Inc, Pfizer, Inc. Pharmacyclics, LLC, Priothera, Sanofi Genzyme, Seagen, Inc. Stemcyte, Takeda Pharmaceuticals, Talaris Therapeutics, Terumo Blood and Cell Technologies, TG Therapeutics, Tscan, Vertex, Vor Biopharma, and Xenikos BV. Conflict of interest statement: A.S. receives support for the conduct of industry sponsored clinical trials from Vertex Pharmaceuticals, CRISPR Therapeutics and Novartis, and consulting fee from Spotlight Therapeutics, Medexus Inc, and Vertex Pharmaceuticals. A.S. also reports receiving honoraria from Vindico Medical Education and research funding from CRISPR Therapeutics. A.S. is supported in part by a Scholar Award by the American Society of Hematology. H.M.L. reports receiving honoraria from Partner Therapeutics and has stock options with Partner Therapeutics. M.A.P. receives honoraria for lectures from Novartis, Bellicum, and Miltenyi. M.A.P. reports receiving travel support from Bellicum and Miltenyi for educational lectures. M.A.P. reports advisory board role for Novartis, Equillium, Medexus, Vertex, and Mesoblast. M.A.P. reports receiving support of materials for IITs from Miltenyi and Adaptive. D.E.Y. reports voluntary (unpaid) technical advisor role for the non-profit entities Cover the Globe and Maipelo Trust. D.E.Y. reports institutional funding from Viracor-Eurofins, Chimerix, and Astellas. M.L.R. reports employment with IQVIA Biotech. M.L.R. reports DSMB committee membership for Gamida cell. M.L.R. reports institutional funding from Atara Bio-Pharma and Jazz Pharmaceuticals. Authorship statement: N.S.B. A.S. M.L.R. C.E.D. and J.J.A. designed the study. A.S.M. M.J.M. and M.L.R. acquired the data and verified it. N.S.B. A.S. A.S.M. M.L.R. C.E.D. M.J.M. and J.J.A. analyzed the data. N.S.B. A.S. M.L.R. C.E.D. and J.J.A. wrote the manuscript, and all other authors critically reviewed the manuscript. N.S.B. and A.S. contributed equally to this work. N.S.B. is listed first because he initiated the project. N.S.B. A.S. A.S.M. M.J.M. M.L.R. C.E.D. and J.J.A. had full access to the data reported in the study. All authors agree with and take full responsibility for the content of this manuscript. Financial disclosure: See Acknowledgments on page 696.e6.
Funding Information:
Conflict of interest statement: A.S. receives support for the conduct of industry sponsored clinical trials from Vertex Pharmaceuticals, CRISPR Therapeutics and Novartis, and consulting fee from Spotlight Therapeutics, Medexus Inc, and Vertex Pharmaceuticals. A.S. also reports receiving honoraria from Vindico Medical Education and research funding from CRISPR Therapeutics. A.S. is supported in part by a Scholar Award by the American Society of Hematology. H.M.L. reports receiving honoraria from Partner Therapeutics and has stock options with Partner Therapeutics. M.A.P. receives honoraria for lectures from Novartis, Bellicum, and Miltenyi. M.A.P. reports receiving travel support from Bellicum and Miltenyi for educational lectures. M.A.P. reports advisory board role for Novartis, Equillium, Medexus, Vertex, and Mesoblast. M.A.P. reports receiving support of materials for IITs from Miltenyi and Adaptive. D.E.Y. reports voluntary (unpaid) technical advisor role for the non-profit entities Cover the Globe and Maipelo Trust. D.E.Y. reports institutional funding from Viracor-Eurofins, Chimerix, and Astellas. M.L.R. reports employment with IQVIA Biotech. M.L.R. reports DSMB committee membership for Gamida cell. M.L.R. reports institutional funding from Atara Bio-Pharma and Jazz Pharmaceuticals.
Publisher Copyright:
© 2022 The American Society for Transplantation and Cellular Therapy
PY - 2022/10
Y1 - 2022/10
N2 - Adult hematopoietic stem cell transplantation (HSCT) recipients are at a high risk of adverse outcomes after COVID-19. Although children have had better outcomes after COVID-19 compared to adults, data on risk factors and outcomes of COVID-19 among pediatric HSCT recipients are lacking. We describe outcomes of HSCT recipients who were ≤21 years of age at COVID-19 diagnosis and were reported to the Center for International Blood and Marrow Transplant Research between March 27, 2020, and May 7, 2021. The primary outcome was overall survival after COVID-19 diagnosis. We determined risk factors of COVID-19 as a secondary outcome in a subset of allogeneic HSCT recipients. A total of 167 pediatric HSCT recipients (135 allogeneic; 32 autologous HSCT recipients) were included. Median time from HSCT to COVID-19 was 15 months (interquartile range [IQR] 7-45) for allogeneic HSCT recipients and 16 months (IQR 6-59) for autologous HSCT recipients. Median follow-up from COVID-19 diagnosis was 53 days (range 1-270) and 37 days (1-179) for allogeneic and autologous HSCT recipients, respectively. Although COVID-19 was mild in 87% (n = 146/167), 10% (n = 16/167) of patients required supplemental oxygen or mechanical ventilation. The 45-day overall survival was 95% (95% confidence interval [CI], 90-99) and 90% (74-99) for allogeneic and autologous HSCT recipients, respectively. Cox regression analysis showed that patients with a hematopoietic cell transplant comorbidity index (HCT-CI) score of 1-2 were more likely to be diagnosed with COVID-19 (hazard ratio 1.95; 95% CI, 1.03-3.69, P = .042) compared to those with an HCT-CI of 0. Pediatric and early adolescent and young adult HSCT recipients with pre-HSCT comorbidities were more likely to be diagnosed with COVID-19. Overall mortality, albeit higher than the reported general population estimates, was lower when compared with previously published data focusing on adult HSCT recipients.
AB - Adult hematopoietic stem cell transplantation (HSCT) recipients are at a high risk of adverse outcomes after COVID-19. Although children have had better outcomes after COVID-19 compared to adults, data on risk factors and outcomes of COVID-19 among pediatric HSCT recipients are lacking. We describe outcomes of HSCT recipients who were ≤21 years of age at COVID-19 diagnosis and were reported to the Center for International Blood and Marrow Transplant Research between March 27, 2020, and May 7, 2021. The primary outcome was overall survival after COVID-19 diagnosis. We determined risk factors of COVID-19 as a secondary outcome in a subset of allogeneic HSCT recipients. A total of 167 pediatric HSCT recipients (135 allogeneic; 32 autologous HSCT recipients) were included. Median time from HSCT to COVID-19 was 15 months (interquartile range [IQR] 7-45) for allogeneic HSCT recipients and 16 months (IQR 6-59) for autologous HSCT recipients. Median follow-up from COVID-19 diagnosis was 53 days (range 1-270) and 37 days (1-179) for allogeneic and autologous HSCT recipients, respectively. Although COVID-19 was mild in 87% (n = 146/167), 10% (n = 16/167) of patients required supplemental oxygen or mechanical ventilation. The 45-day overall survival was 95% (95% confidence interval [CI], 90-99) and 90% (74-99) for allogeneic and autologous HSCT recipients, respectively. Cox regression analysis showed that patients with a hematopoietic cell transplant comorbidity index (HCT-CI) score of 1-2 were more likely to be diagnosed with COVID-19 (hazard ratio 1.95; 95% CI, 1.03-3.69, P = .042) compared to those with an HCT-CI of 0. Pediatric and early adolescent and young adult HSCT recipients with pre-HSCT comorbidities were more likely to be diagnosed with COVID-19. Overall mortality, albeit higher than the reported general population estimates, was lower when compared with previously published data focusing on adult HSCT recipients.
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UR - http://www.scopus.com/inward/citedby.url?scp=85136313619&partnerID=8YFLogxK
U2 - 10.1016/j.jtct.2022.06.026
DO - 10.1016/j.jtct.2022.06.026
M3 - Article
C2 - 35798233
AN - SCOPUS:85136313619
SN - 2666-6375
VL - 28
SP - 696.e1-696.e7
JO - Transplantation and Cellular Therapy
JF - Transplantation and Cellular Therapy
IS - 10
ER -