Australia and New Zealand Transplant and Cellular Therapies (ANZTCT) position statement: COVID-19 management in patients with haemopoietic stem cell transplant and chimeric antigen receptor T cell

Jacinta Perram; Duncan Purtill; Ashish Bajel; Jason Butler; Tracey O'Brien; Benjamin Teh; Nicole Gilroy; Phoebe J Ho; Richard Doocey; Thomas Hills; Travis Perera; Genevieve Douglas; Shanti Ramachandran; Lynette Chee; Judith Trotman; Robert Weinkove; Steven Keogh; Chris Fraser; Tara Cochrane; Anne-Marie Watson; Peter Diamond; Maya Latimer; Ian Irving; Emily Blyth; Chan Cheah; Theresa Cole; Sam Milliken; Hung Yang; Matthew Greenwood; Peter Bardy; Glen Kennedy; Stephen Larsen; Rachel Conyers; Nada Hamad

doi:10.1111/imj.15978

Australia and New Zealand Transplant and Cellular Therapies (ANZTCT) position statement: COVID-19 management in patients with haemopoietic stem cell transplant and chimeric antigen receptor T cell

Intern Med J. 2023 Jan;53(1):119-125. doi: 10.1111/imj.15978.

Authors

Jacinta Perram¹, Duncan Purtill², Ashish Bajel³, Jason Butler⁴, Tracey O'Brien⁵, Benjamin Teh⁶, Nicole Gilroy⁷, Phoebe J Ho⁸, Richard Doocey⁹, Thomas Hills⁹, Travis Perera¹⁰, Genevieve Douglas¹¹, Shanti Ramachandran¹², Lynette Chee³, Judith Trotman¹³, Robert Weinkove¹⁴, Steven Keogh¹⁵, Chris Fraser¹⁶, Tara Cochrane¹⁷, Anne-Marie Watson¹⁸, Peter Diamond¹⁹, Maya Latimer²⁰, Ian Irving²¹, Emily Blyth¹⁵, Chan Cheah²², Theresa Cole²³, Sam Milliken²⁴, Hung Yang²⁵, Matthew Greenwood²⁶, Peter Bardy²⁷, Glen Kennedy⁴, Stephen Larsen⁸, Rachel Conyers²³, Nada Hamad^{24

28}

Affiliations

¹ Haematology Department, Westmead Hospital, Sydney, New South Wales, Australia.
² Haematology department, Fiona Stanley Hospital, Western Australia, Perth, Australia.
³ Clinical Haematology, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
⁴ Haematology department, Royal Brisbane and Women's Hospital, Queensland, Brisbane, Australia.
⁵ Haematology department, Sydney Children's Hospital, New South Wales, Sydney, Australia.
⁶ Haematology department, National Centre for Infections in Cancer and Department of Infectious Diseases, Peter MacCallum Cancer Institute, Victoria, Melbourne, Australia.
⁷ Haematology department, Centre for Infectious Diseases and Microbiology, Westmead Hospital, New South Wales, Sydney, Australia.
⁸ Haematology department, Royal Prince Alfred Hospital and the University of Sydney, New South Wales, Sydney, Australia.
⁹ Haematology department, Auckland City Hospital, Auckland, New Zealand.
¹⁰ Haematology department, Wellington Blood and Cancer Centre, Wellington, New Zealand.
¹¹ Haematology department, Austin Hospital, Victoria, Melbourne, Australia.
¹² Department of Clinical Haematology, Oncology, Blood and Marrow Transplantation, Perth Children's Hospital, Perth, Western Australia, Australia.
¹³ Haematology department, Concord Repatriation General Hospital and University of Sydney, New South Wales, Sydney, Australia.
¹⁴ Haematology department, Wellington Blood and Cancer Centre and Cancer Immunotherapy Programme, Malaghan Institute of Medical Research, Wellington, New Zealand.
¹⁵ Haematology department, University of Sydney and Westmead Hospital, New South Wales, Sydney, Australia.
¹⁶ Haematology department, Children's Health Queensland Hospital and Health Service, Queensland, Brisbane, Australia.
¹⁷ Haematology department, Gold Coast University Hospital, Queensland, Gold Coast, Australia.
¹⁸ Haematology department, Liverpool Hospital, New South Wales, Sydney, Australia.
¹⁹ Leukaemia Foundation, Sydney, New South Wales, Australia.
²⁰ Haematology department, Canberra Hospital, Australian Capital Territory, Canberra, Australia.
²¹ ICON Cancer Centre, Brisbane, Queensland, Australia.
²² Haematology department, Sir Charles Gairdner Hospital, Western Australia, Perth, Australia.
²³ Haematology department, The Royal Children's Hospital Melbourne, Victoria, Melbourne, Australia.
²⁴ Haematology department, St Vincent's Hospital Sydney and School of Clinical Medicine, Faculty of Medicine and Health, UNSW, New South Wales, Sydney, Australia.
²⁵ Australian Bone Marrow Donor Registry, Sydney, New South Wales, Australia.
²⁶ Haematology department, Royal North Shore Hospital, New South Wales, Sydney, Australia.
²⁷ Haematology department, Royal Adelaide Hospital, South Australia, Adelaide, Australia.
²⁸ Haematology department, School of Medicine Sydney Campus, University of Notre Dame Australia, New South Wales, Sydney, Australia.

Abstract

Patients with post-haemopoietic stem cell transplant or chimeric antigen receptor T -cell (CAR-T) therapy face a significant risk of morbidity and mortality from coronavirus disease 2019 because of their immunosuppressed state. As case numbers in Australia and New Zealand continue to rise, guidance on management in this high-risk population is needed. Whilst we have learned much from international colleagues who faced high infection rates early in the pandemic, guidance relevant to local health system structures, medication availability and emerging therapies is essential to equip physicians to manage our patients optimally.

Keywords: CAR-T cell; COVID-19; allogeneic stem cell transplant; autologous stem cell transplant.

MeSH terms

COVID-19*
Hematopoietic Stem Cell Transplantation*
Humans
New Zealand / epidemiology
Receptors, Chimeric Antigen* / therapeutic use
T-Lymphocytes

Substances

Receptors, Chimeric Antigen