![]() The case cohort (cohort A) consisted of patients who underwent HSCT or CAR-T therapy from 15 March to 15 June 2020, whereas the prepandemic control cohort (cohort B) included HSCT or CAR-T patients treated from 15 December 2019 to 14 March 2020. We analyzed all adult patients who underwent allo-HSCT, auto-HSCT, and CAR-T therapy from Decemto Jat the DFCI/BWCC. Data on the impact of donor product cryopreservation were obtained from our cell manipulation core facility. Assessment of donor workflow disruptions and data regarding unrelated donor product procurement were obtained from our donor services team, in conjunction with the National Donor Marrow Program (NMDP). This study was approved by the Institutional Review Board of the DFCI/Brigham and Women’s Cancer Center (BWCC). Restrictions on travel rendered evaluation difficult for prospective donors out of concern for travel-related COVID-19 exposures. 2-4 The ban on international air travel and interruption of domestic routes disrupted the reliable transport of donor products. ![]() Guidance from the European Society for Blood and Marrow Transplantation included deferral of nonurgent transplants when possible. Many other transplant programs were forced to reduce transplant volume, if not stop completely. This abrupt shutdown presented major challenges in coordination and delivery of hematopoietic stem cell transplant (HSCT) and immune cell–based therapies, including chimeric antigen receptor T cells (CAR-T). 1 The first case of COVID-19 reported from community spread in the United States occurred in February 2020, and a nationwide lockdown was declared in the United States on 15 March 2020 to curb the rapid rise in cases. The novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which leads to the infectious respiratory disease COVID-19, emerged in the city of Wuhan, China, in late 2019, spread worldwide within 3 months, and was declared a pandemic by the World Health Organization on 11 March 2020. ![]() Altogether, our data indicate that cellular therapies can be safely administered throughout the ongoing COVID-19 pandemic with appropriate safeguards. One CAR-T patient contracted COVID-19 at day +51 and died of the disease. ![]() No HSCT patients contracted COVID-19 between days 0 and 100. ![]() Although there were changes in donor selection and screening as well as cryopreservation patterns of donor products, no differences were observed across groups in 100-day overall survival, progression-free survival, rates of non–COVID-19 infections, including hospital length of stay, neutrophil engraftment, graft failure, acute graft-versus-host disease in allo-HSCT patients, or cytokine release syndrome and neurotoxicity in CAR-T patients. A second control cohort was evaluated for HSCT groups to reflect seasonal variation in infections. Outcomes were compared with 66 allo-HSCT, 43 auto-HSCT, and 33 CAR-T patients treated prior to the pandemic. We sought to assess the impact of the COVID-19 pandemic on operations and clinical outcomes for HSCT and CAR-T cellular therapies at the Dana-Farber Cancer Institute by reviewing administration and outcomes in 127 cell therapy patients treated during the initial COVID-19 surge: 62 adult allogeneic HSCT (allo-HSCT), 38 autologous HSCT (auto-HSCT), and 27 CAR-T patients. Widespread community transmission in the United States triggered a nationwide shutdown, raising major challenges for administration of hematopoietic stem cell transplant (HSCT) and chimeric antigen receptor (CAR)-T cell therapies, leading many centers to delay or cancel operations. The novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), identified in late 2019 as the causative agent of COVID-19, was declared a pandemic by the World Health Organization on 11 March 2020. ![]()
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