Prior COVID-19 infection may increase risk for developing endothelial dysfunction following hematopoietic cell transplantation
Endothelial dysfunction underlies many of the major complications following hematopoietic cell transplantation (HCT), including transplant-associated thrombotic microangiopathy (TA-TMA), veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS), and engraftment syndrome (ES). Emerging evidenc...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.1000215/full |
| _version_ | 1797951484683354112 |
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| author | Sydney Ariagno Dristhi Ragoonanan Sajad Khazal Kris M. Mahadeo Gabriel Salinas Cisneros Matt S. Zinter Robyn A. Blacken Gopi Mohan Gopi Mohan Leslie E. Lehmann Asmaa Ferdjallah Kristin C. Mara Mira A. Kohorst |
| author_facet | Sydney Ariagno Dristhi Ragoonanan Sajad Khazal Kris M. Mahadeo Gabriel Salinas Cisneros Matt S. Zinter Robyn A. Blacken Gopi Mohan Gopi Mohan Leslie E. Lehmann Asmaa Ferdjallah Kristin C. Mara Mira A. Kohorst |
| author_sort | Sydney Ariagno |
| collection | DOAJ |
| description | Endothelial dysfunction underlies many of the major complications following hematopoietic cell transplantation (HCT), including transplant-associated thrombotic microangiopathy (TA-TMA), veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS), and engraftment syndrome (ES). Emerging evidence similarly implicates endothelitis and microangiopathy in severe COVID-19-related multi-system organ dysfunction. Given the overlap in these two illness states, we hypothesize that prior COVID-19 infection may increase risk for HCT-related endotheliopathies. This retrospective, multicenter study included patients aged 0-25 years who underwent autologous or allogeneic HCT for any indication between January 1, 2020 and September 21, 2021, with close attention to those infected with COVID-19 in either the six months prior to transplant or twelve months following transplant. Incidences of TA-TMA, VOD/SOS, and ES were compared among patients with COVID-19 infection pre-HCT and post-HCT, as well as with historical controls who were never infected with SARS-CoV-2. Those who underwent HCT following COVID-19 infection displayed significantly increased rates of TA-TMA compared to those who were never infected. Additionally, our data suggests a similar trend for increased VOD/SOS and ES rates, although this did not reach statistical significance. Therefore, a history of COVID-19 infection prior to undergoing HCT may be a nonmodifiable risk factor for endothelial-related complications following HCT. Further studies are warranted to better clarify this relationship among larger cohorts and in the era of the Omicron SARS-CoV-2 variants. |
| first_indexed | 2024-04-10T22:31:21Z |
| format | Article |
| id | doaj.art-fc05838b5e864dd8a37c73d98de0f219 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-10T22:31:21Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-fc05838b5e864dd8a37c73d98de0f2192023-01-17T04:50:32ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-01-011210.3389/fonc.2022.10002151000215Prior COVID-19 infection may increase risk for developing endothelial dysfunction following hematopoietic cell transplantationSydney Ariagno0Dristhi Ragoonanan1Sajad Khazal2Kris M. Mahadeo3Gabriel Salinas Cisneros4Matt S. Zinter5Robyn A. Blacken6Gopi Mohan7Gopi Mohan8Leslie E. Lehmann9Asmaa Ferdjallah10Kristin C. Mara11Mira A. Kohorst12Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, United StatesDivision of Pediatrics, Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDivision of Pediatrics, Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDivision of Pediatrics, Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesPediatric Hematology and Oncology, University of California San Francisco, San Francisco, CA, United StatesPediatric Critical Care Medicine, University of California San Francisco, San Francisco, CA, United StatesCancer and Blood Disorders Center, Boston Children’s Hospital, Boston, MA, United StatesPediatric Critical Care, Massachusetts General Hospital, Boston, MA, United StatesHematology-Oncology, Boston Children’s Hospital, Boston, MA, United StatesPediatric Stem Cell Transplant, Dana Farber Cancer Institute/Boston Children’s Hospital, Boston, MA, United StatesPediatric Hematology and Oncology, Mayo Clinic, Rochester, MN, United States0Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United StatesPediatric Hematology and Oncology, Mayo Clinic, Rochester, MN, United StatesEndothelial dysfunction underlies many of the major complications following hematopoietic cell transplantation (HCT), including transplant-associated thrombotic microangiopathy (TA-TMA), veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS), and engraftment syndrome (ES). Emerging evidence similarly implicates endothelitis and microangiopathy in severe COVID-19-related multi-system organ dysfunction. Given the overlap in these two illness states, we hypothesize that prior COVID-19 infection may increase risk for HCT-related endotheliopathies. This retrospective, multicenter study included patients aged 0-25 years who underwent autologous or allogeneic HCT for any indication between January 1, 2020 and September 21, 2021, with close attention to those infected with COVID-19 in either the six months prior to transplant or twelve months following transplant. Incidences of TA-TMA, VOD/SOS, and ES were compared among patients with COVID-19 infection pre-HCT and post-HCT, as well as with historical controls who were never infected with SARS-CoV-2. Those who underwent HCT following COVID-19 infection displayed significantly increased rates of TA-TMA compared to those who were never infected. Additionally, our data suggests a similar trend for increased VOD/SOS and ES rates, although this did not reach statistical significance. Therefore, a history of COVID-19 infection prior to undergoing HCT may be a nonmodifiable risk factor for endothelial-related complications following HCT. Further studies are warranted to better clarify this relationship among larger cohorts and in the era of the Omicron SARS-CoV-2 variants.https://www.frontiersin.org/articles/10.3389/fonc.2022.1000215/fullCOVID-19hematopoietic cell transplantTA-TMAVOD/SOSengraftment syndromeendothelial dysfunction |
| spellingShingle | Sydney Ariagno Dristhi Ragoonanan Sajad Khazal Kris M. Mahadeo Gabriel Salinas Cisneros Matt S. Zinter Robyn A. Blacken Gopi Mohan Gopi Mohan Leslie E. Lehmann Asmaa Ferdjallah Kristin C. Mara Mira A. Kohorst Prior COVID-19 infection may increase risk for developing endothelial dysfunction following hematopoietic cell transplantation Frontiers in Oncology COVID-19 hematopoietic cell transplant TA-TMA VOD/SOS engraftment syndrome endothelial dysfunction |
| title | Prior COVID-19 infection may increase risk for developing endothelial dysfunction following hematopoietic cell transplantation |
| title_full | Prior COVID-19 infection may increase risk for developing endothelial dysfunction following hematopoietic cell transplantation |
| title_fullStr | Prior COVID-19 infection may increase risk for developing endothelial dysfunction following hematopoietic cell transplantation |
| title_full_unstemmed | Prior COVID-19 infection may increase risk for developing endothelial dysfunction following hematopoietic cell transplantation |
| title_short | Prior COVID-19 infection may increase risk for developing endothelial dysfunction following hematopoietic cell transplantation |
| title_sort | prior covid 19 infection may increase risk for developing endothelial dysfunction following hematopoietic cell transplantation |
| topic | COVID-19 hematopoietic cell transplant TA-TMA VOD/SOS engraftment syndrome endothelial dysfunction |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.1000215/full |
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