First results of the EBMT prospective survey on impact of COVID-19 on stem cell transplant recipients and patients treated with CAR T cells
The new coronavirus SARS-CoV-2 is raging through Europe and unfortunately has caused a large number of deaths primarily in risk groups such as the elderly and in individuals with co-morbidities. The information about the effects of this virus and its associated disease covid-19 in stem cell transplant recipients and patients undergoing CAR T cell therapy is very limited. We know that other respiratory viruses cause significant morbidity and mortality in these patient groups. The Infectious Diseases Working Party of the EBMT therefore decided in collaboration with the Spanish Group (GETH) to collect information about verified cases of covid-19 in these patient groups. Data is collected in three steps: First a registration form, second a very brief interim form two weeks after the diagnosis of covid-19, and finally a complete follow-up form when the episode is over either by virologic resolution, clinical resolution, or death. The registration form includes data on symptoms at diagnosis, type of transplant, gender, age, and time from transplant to covid-19. The interim form only information if the patient has needed intensive care and if he/she is alive or dead at that time point while the final follow-up form includes information about co-morbidities, eventually given treatments, immunosuppression, laboratory values, and outcome.
The data collection started March 1 now 8 weeks later, we have more than 130 cases registered from 13 countries with the largest number of registrations coming from Spain and Italy. The distribution of the registrations is X received on allogeneic recipients, Y on autologous, and Z on patients treated with CAR T cells.
We presented the first analysis of early obtained data in a webinar arranged together with the American Society of Transplantation and Cellular Therapy (ASTCT). The median age of the first 98 allogeneic patients was 54 years and of the first 29 autologous patients 59 years. Fourteen allogeneic recipients were below 18 years of age. The median time from transplant to covid-19 diagnosis was 10 months in allogeneic patients and 13 months in autologous patients. 36% of the patients had lower respiratory tract disease already at diagnosis. It should be recognized that the follow-up data is still very incomplete but the early mortality (at about two weeks after diagnosis) was approximately 20% in allogeneic stem cell transplant recipients and 10% in autologous stem cell transplant recipients. This is based on the interim reports on 55 patients; 44 allogeneic and 11 autologous stem cell transplant recipients.
It is far too early to know if these very early figures will be representative when more information has been collected and it is therefore urgently needed to get as complete information as quickly as possible. We therefore hope that the EBMT community continue to support this prospective survey to help centers to manage their patients with covid-19.