Improved outcomes over time and higher mortality in CMV seropositive allogeneic stem cell transplantation patients with COVID-19; An infectious disease working party study from the European Society for Blood and Marrow Transplantation registry
IntroductionCOVID-19 has been associated with high morbidity and mortality in allogeneic hematopoietic stem cell transplant (allo-HCT) recipients.MethodsThis study reports on 986 patients reported to the EBMT registry during the first 29 months of the pandemic.ResultsThe median age was 50.3 years (m...
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| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Immunology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1125824/full |
| _version_ | 1827997639299301376 |
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| author | Per Ljungman Per Ljungman Gloria Tridello Jose Luis Piñana Jose Luis Piñana Fabio Ciceri Henrik Sengeloev Alexander Kulagin Stephan Mielke Stephan Mielke Zeynep Arzu Yegin Matthew Collin Sigrun Einardottir Sigrun Einardottir Sophie Ducastelle Lepretre Johan Maertens Antonio Campos Elisabetta Metafuni Herbert Pichler Frantisek Folber Frantisek Folber Carlos Solano Emma Nicholson Meltem Kurt Yüksel Kristina Carlson Beatriz Aguado Caroline Besley Jenny Byrne Immaculada Heras Fiona Dignan Nicolaus Kröger Christine Robin Anjum Khan Stig Lenhoff Anna Grassi Veronika Dobsinska Nuno Miranda Maria-Jose Jimenez Ipek Yonal-Hindilerden Keith Wilson Dina Averbuch Simone Cesaro Alienor Xhaard Nina Knelange Jan Styczynski Malgorzata Mikulska Rafael de la Camara |
| author_facet | Per Ljungman Per Ljungman Gloria Tridello Jose Luis Piñana Jose Luis Piñana Fabio Ciceri Henrik Sengeloev Alexander Kulagin Stephan Mielke Stephan Mielke Zeynep Arzu Yegin Matthew Collin Sigrun Einardottir Sigrun Einardottir Sophie Ducastelle Lepretre Johan Maertens Antonio Campos Elisabetta Metafuni Herbert Pichler Frantisek Folber Frantisek Folber Carlos Solano Emma Nicholson Meltem Kurt Yüksel Kristina Carlson Beatriz Aguado Caroline Besley Jenny Byrne Immaculada Heras Fiona Dignan Nicolaus Kröger Christine Robin Anjum Khan Stig Lenhoff Anna Grassi Veronika Dobsinska Nuno Miranda Maria-Jose Jimenez Ipek Yonal-Hindilerden Keith Wilson Dina Averbuch Simone Cesaro Alienor Xhaard Nina Knelange Jan Styczynski Malgorzata Mikulska Rafael de la Camara |
| author_sort | Per Ljungman |
| collection | DOAJ |
| description | IntroductionCOVID-19 has been associated with high morbidity and mortality in allogeneic hematopoietic stem cell transplant (allo-HCT) recipients.MethodsThis study reports on 986 patients reported to the EBMT registry during the first 29 months of the pandemic.ResultsThe median age was 50.3 years (min – max; 1.0 – 80.7). The median time from most recent HCT to diagnosis of COVID-19 was 20 months (min – max; 0.0 – 383.9). The median time was 19.3 (0.0 - 287.6) months during 2020, 21.2 (0.1 - 324.5) months during 2021, and 19.7 (0.1 – 383.9) months during 2022 (p = NS). 145/986 (14.7%) patients died; 124 (12.6%) due to COVID-19 and 21 of other causes. Only 2/204 (1%) fully vaccinated patients died from COVID-19. There was a successive improvement in overall survival over time. In multivariate analysis, increasing age (p<.0001), worse performance status (p<.0001), contracting COVID-19 within the first 30 days (p<.0001) or 30 – 100 days after HCT (p=.003), ongoing immunosuppression (p=.004), pre-existing lung disease (p=.003), and recipient CMV seropositivity (p=.004) had negative impact on overall survival while patients contracting COVID-19 in 2020 (p<.0001) or 2021 (p=.027) had worse overall survival than patients with COVID-19 diagnosed in 2022.DiscussionAlthough the outcome of COVID-19 has improved, patients having risk factors were still at risk for severe COVID-19 including death. |
| first_indexed | 2024-04-10T05:32:12Z |
| format | Article |
| id | doaj.art-34d0341b3015429d8b862b7e7130e615 |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-10T05:32:12Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-34d0341b3015429d8b862b7e7130e6152023-03-07T05:45:23ZengFrontiers Media S.A.Frontiers in Immunology1664-32242023-03-011410.3389/fimmu.2023.11258241125824Improved outcomes over time and higher mortality in CMV seropositive allogeneic stem cell transplantation patients with COVID-19; An infectious disease working party study from the European Society for Blood and Marrow Transplantation registryPer Ljungman0Per Ljungman1Gloria Tridello2Jose Luis Piñana3Jose Luis Piñana4Fabio Ciceri5Henrik Sengeloev6Alexander Kulagin7Stephan Mielke8Stephan Mielke9Zeynep Arzu Yegin10Matthew Collin11Sigrun Einardottir12Sigrun Einardottir13Sophie Ducastelle Lepretre14Johan Maertens15Antonio Campos16Elisabetta Metafuni17Herbert Pichler18Frantisek Folber19Frantisek Folber20Carlos Solano21Emma Nicholson22Meltem Kurt Yüksel23Kristina Carlson24Beatriz Aguado25Caroline Besley26Jenny Byrne27Immaculada Heras28Fiona Dignan29Nicolaus Kröger30Christine Robin31Anjum Khan32Stig Lenhoff33Anna Grassi34Veronika Dobsinska35Nuno Miranda36Maria-Jose Jimenez37Ipek Yonal-Hindilerden38Keith Wilson39Dina Averbuch40Simone Cesaro41Alienor Xhaard42Nina Knelange43Jan Styczynski44Malgorzata Mikulska45Rafael de la Camara46Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska Comprehensive Cancer Center, Karolinska University Hospital Huddinge, Stockholm, SwedenDivision of Hematology, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, SwedenEuropean Society for Blood and Marrow Transplantation (EBMT) Data Office, Department of Medical Statistics & Bioinformatics, Leiden, NetherlandsHematology Department, Hospital Clínico Universitario de Valencia, Valencia, SpainFundación Investigación del Hospital Clínico de la Comunidad Valenciana (INCLIVA), Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia, Valencia, SpainIstituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale San Raffaele, University Vita-Salute San Raffaele, Milan, ItalyDepartment of Hematology, Copenhagen University Hospital, Copenhagen, DenmarkRaisa Memorial (RM) Gorbacheva Research Institute, Pavlov University, St. Petersburg, RussiaDepartment of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska Comprehensive Cancer Center, Karolinska University Hospital Huddinge, Stockholm, SwedenDepartment of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden0Department of Hematology, Gazi University Faculty of Medicine, Ankara, Türkiye1Translational and Clinical Research Institute and The National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre, Newcastle, United Kingdom2Department of Hematology, Sahlgrenska University Hospital, Gothenburg, Sweden3Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden4Service d’Hématologie. Hôpital Lyon Sud, Lyon, France5Department of Hematology University Hospital Gasthuisberg, Leuven, Belgium6Marrow Transplant Department Inst. Português de Oncologia do Porto, Porto, Portugal7Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica e Ematologia, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy8St. Anna Children’s Hospital, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria9Department of Internal Medicine, Hematology and Oncology University Hospital Brno, Brno, Czechia0Department of Internal Medicine, Hematology and Oncology Masaryk University, Brno, CzechiaEuropean Society for Blood and Marrow Transplantation (EBMT) Data Office, Department of Medical Statistics & Bioinformatics, Leiden, Netherlands1Haematology-oncology Unit Royal Marsden Hospital, London, United Kingdom2Department of Hematology, Ankara University Faculty of Medicine, Ankara, Türkiye3Department of Hematology, Uppsala University Hospital, Uppsala, Sweden4Department of Hematology, Hospital Universitario de la Princesa, Madrid, Spain5University Hospitals Bristol and Weston National Health Service (NHS) Foundation Trust, Bristol, United Kingdom6Department of Haematology Nottingham University Hospital, Nottingham, United Kingdom7Department of Hematology, Hospital Universitario Morales Meseguer, Instituto Murciano de Investigación Biosanitaria (IMIB)-Arrixaca, Universidad de Murcia, Murcia, Spain8Clinical Haematology Department Manchester Royal Infirmary, Manchester, United Kingdom9Department of Stem cell Transplantation, University Hospital Eppendorf, Hamburg, Germany0Assistance Publique-Hôpitaux de Paris (APHP), Henri Mondor Hospital, Department of Hematology, Créteil, France1Department of Haematology Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom2Department of Hematology Skåne’s University Hospital, Lund, Sweden3Bone Marrow Transplantation Unit, Azienda Sociosanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy4Department of Pediatric Hematology and Oncology, National Institute of Children’s Diseases, Comenius University, Bratislava, Slovakia5Department of Haematology Inst. Portugues Oncologia, Lisbon, Portugal6Department of Clinical Haematology Institut Catala d'Oncologia (ICO)-Hospital Universitari Germans Trias i Pujol, Badalona, Spain7Istanbul Medical Faculty, Adult Hematopoietic Stem Cell Transplant Center, Istanbul University, Istanbul, Türkiye8Blood and Bone Marrow Transplantation Department University of Cardiff, Cardiff, United Kingdom9Pediatric Infectious Diseases Unit, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel0Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy1Hematology-Transplantation Unit, Department of Hematology: Hôpital St. Louis, Paris, France2European Society for Blood and Marrow Transplantation (EBMT) Leiden Study Unit, European Society for Blood and Marrow Transplantation (EBMT) Data Office, Leiden, Netherlands3Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland4Division of Infectious Diseases, University of Genoa and Ospedale Policlinico San Martino, Genova, Italy4Department of Hematology, Hospital Universitario de la Princesa, Madrid, SpainIntroductionCOVID-19 has been associated with high morbidity and mortality in allogeneic hematopoietic stem cell transplant (allo-HCT) recipients.MethodsThis study reports on 986 patients reported to the EBMT registry during the first 29 months of the pandemic.ResultsThe median age was 50.3 years (min – max; 1.0 – 80.7). The median time from most recent HCT to diagnosis of COVID-19 was 20 months (min – max; 0.0 – 383.9). The median time was 19.3 (0.0 - 287.6) months during 2020, 21.2 (0.1 - 324.5) months during 2021, and 19.7 (0.1 – 383.9) months during 2022 (p = NS). 145/986 (14.7%) patients died; 124 (12.6%) due to COVID-19 and 21 of other causes. Only 2/204 (1%) fully vaccinated patients died from COVID-19. There was a successive improvement in overall survival over time. In multivariate analysis, increasing age (p<.0001), worse performance status (p<.0001), contracting COVID-19 within the first 30 days (p<.0001) or 30 – 100 days after HCT (p=.003), ongoing immunosuppression (p=.004), pre-existing lung disease (p=.003), and recipient CMV seropositivity (p=.004) had negative impact on overall survival while patients contracting COVID-19 in 2020 (p<.0001) or 2021 (p=.027) had worse overall survival than patients with COVID-19 diagnosed in 2022.DiscussionAlthough the outcome of COVID-19 has improved, patients having risk factors were still at risk for severe COVID-19 including death.https://www.frontiersin.org/articles/10.3389/fimmu.2023.1125824/fullCOVID-19allogeneicstem cell transplantationCMVrisk factors |
| spellingShingle | Per Ljungman Per Ljungman Gloria Tridello Jose Luis Piñana Jose Luis Piñana Fabio Ciceri Henrik Sengeloev Alexander Kulagin Stephan Mielke Stephan Mielke Zeynep Arzu Yegin Matthew Collin Sigrun Einardottir Sigrun Einardottir Sophie Ducastelle Lepretre Johan Maertens Antonio Campos Elisabetta Metafuni Herbert Pichler Frantisek Folber Frantisek Folber Carlos Solano Emma Nicholson Meltem Kurt Yüksel Kristina Carlson Beatriz Aguado Caroline Besley Jenny Byrne Immaculada Heras Fiona Dignan Nicolaus Kröger Christine Robin Anjum Khan Stig Lenhoff Anna Grassi Veronika Dobsinska Nuno Miranda Maria-Jose Jimenez Ipek Yonal-Hindilerden Keith Wilson Dina Averbuch Simone Cesaro Alienor Xhaard Nina Knelange Jan Styczynski Malgorzata Mikulska Rafael de la Camara Improved outcomes over time and higher mortality in CMV seropositive allogeneic stem cell transplantation patients with COVID-19; An infectious disease working party study from the European Society for Blood and Marrow Transplantation registry Frontiers in Immunology COVID-19 allogeneic stem cell transplantation CMV risk factors |
| title | Improved outcomes over time and higher mortality in CMV seropositive allogeneic stem cell transplantation patients with COVID-19; An infectious disease working party study from the European Society for Blood and Marrow Transplantation registry |
| title_full | Improved outcomes over time and higher mortality in CMV seropositive allogeneic stem cell transplantation patients with COVID-19; An infectious disease working party study from the European Society for Blood and Marrow Transplantation registry |
| title_fullStr | Improved outcomes over time and higher mortality in CMV seropositive allogeneic stem cell transplantation patients with COVID-19; An infectious disease working party study from the European Society for Blood and Marrow Transplantation registry |
| title_full_unstemmed | Improved outcomes over time and higher mortality in CMV seropositive allogeneic stem cell transplantation patients with COVID-19; An infectious disease working party study from the European Society for Blood and Marrow Transplantation registry |
| title_short | Improved outcomes over time and higher mortality in CMV seropositive allogeneic stem cell transplantation patients with COVID-19; An infectious disease working party study from the European Society for Blood and Marrow Transplantation registry |
| title_sort | improved outcomes over time and higher mortality in cmv seropositive allogeneic stem cell transplantation patients with covid 19 an infectious disease working party study from the european society for blood and marrow transplantation registry |
| topic | COVID-19 allogeneic stem cell transplantation CMV risk factors |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1125824/full |
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