Two years into the SARS-CoV-2 (COVID-19) pandemic, novel challenges continue to emerge. As the community moves towards high daily case numbers and circulating virus, or so called “COVID normal”, the risk for adult immunocompromised patients remains high. 1 In the paediatric setting data is lacking and the risks of morbidity and mortality are likely lower than in the adult setting.
In addition to the physical risk of COVID-19, there are additional psychosocial implications for patients who have received haematopoietic stem cell transplants and chimeric antigen receptor T cell therapies (TCT). Many patients report significant anxiety about COVID-19, and it is not always safe to isolate in the early post TCT period as patients recuperate at home post discharge.2 Another challenge in this cohort is prolonged post infection viral shedding, which can create challenges for access to medical care as well as other household members needing to isolate.
Transplant and cellular therapies are life-saving interventions and cannot routinely be postponed due to the risk of intervening disease relapse. This has forced great innovation and collaboration internationally by TCT clinicians to ensure access to safe and timely therapy against COVID-19 for TCT patients.
This position statement is intended to highlight relevant clinical issues unique to TCT patients and was developed in accordance with the ANZTCT policy for consensus practice/position statement development. The relevant literature has been reviewed and selected by the expert authors. The authorship group includes ANZTCT board members who have sought representatives from all TCT centres in Australia and New Zealand and key stakeholders including the Australasian Society of Infectious Diseases, the Haematology Society of Australia and New Zealand, the Australian and New Zealand Bone Marrow Donor Registries, Leukaemia foundation and Leukaemia and Blood Cancer New Zealand. The ANZTCT is committed to equity, diversity and inclusion so geographic representation, gender balance and diversity of backgrounds and disciplines was considered where possible.
Read the full position statement here.
This position statement will be regularly reviewed and updated as further data on COVID-19 therapeutics emerge.