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Blood ; 136(Supplement 1):3-4, 2020.
Article in English | PMC | ID: covidwho-1339110


Introduction: Children with newly diagnosed acute myeloid leukemia (AML) may have a high early mortality when resources are limited by infrastructure or by a widespread worldwide crisis, as being faced with the SARS-Cov-2 pandemic. Many elective treatments were postponed, but newly diagnosed AML is a life-threatening disease that needs prompt therapy. With acute shortage of infra-structure as intensive care unit beds, blood supply, medication, healthcare personnel, an optimal therapy must balance anti-neoplastic efficacy and the chance of treatment-related mortality. The induction chemotherapy of pediatric patients with AML living in low- and middle-income countries has been thoroughly discussed because early mortality remains 10%-20%, much higher than in developed counties. Mild treatment schemas have been used in Japan, China and Latin America with impressive results, comparable to other intensive induction regimens. Our objective is to describe the results of this mild induction regimen used in Brazil to treat children simultaneously diagnosed with AML and Covid-19 infections.Methods: This is a retrospective multicentric trial including Brazilian children diagnosed with AML, also found to have a positive nasal and oropharyngeal PCR for SARS-Cov-2 and uniformly treated with mild induction protocol ("MAG") that included Mitoxantrone at 5 mg/m2, by i.v. infusion over 4 to 6 hours once a day on days 1, 3, and 5 (three doses in total), Cytarabine at 10 mg/m2, subcutaneous (s.c.), q 12 h for 10 days (20 doses in total) and G-CSF 5

Transplant Cell Ther ; 27(3): 270.e1-270.e6, 2021 03.
Article in English | MEDLINE | ID: covidwho-1108498


SARS-CoV-2 has spread rapidly worldwide, but the full impact of the COVID-19 pandemic on the field of hematopoietic cell transplantation (HCT) remains unknown. To understand this better, an 18-item online survey was disseminated by the Worldwide Network for Blood & Marrow Transplantation with questions exploring SARS-CoV-2 testing algorithms, mobilization, and cryopreservation strategies and COVID-19 infections in allogeneic related and autologous hematopoietic progenitor cell (HPC) donors. The aim of this survey was to assess the impact of the outbreak on policies relating to HPC mobilization, collection, and processing with respect to changes in daily routine. A total of 91 individual responses from distinct centers in 6 continents were available for analysis. In these centers, the majority (72%) of allogeneic related and autologous donors are routinely tested for SARS-CoV-2 before HPC collection, and 80% of centers implement cryopreservation of allogeneic HPC grafts before commencing conditioning regimens in patients. Five related and 14 autologous donors who tested positive for COVID-19 did not experience any unexpected adverse events or reactions during growth factor administration (eg, hyperinflammatory syndrome). These data are limited by the small number of survey respondents but nonetheless suggest that centers are following the recommendations of appropriate scientific organizations and provide some preliminary data to suggest areas of further study.

Bone Marrow Transplantation/statistics & numerical data , COVID-19/epidemiology , Hematopoietic Stem Cell Transplantation/statistics & numerical data , Pandemics , SARS-CoV-2 , Algorithms , Allografts , Bone Marrow Transplantation/trends , COVID-19/diagnosis , COVID-19/prevention & control , COVID-19 Testing/methods , COVID-19 Testing/statistics & numerical data , Cryopreservation/methods , Donor Selection/standards , Global Health , Health Care Surveys , Hematopoietic Stem Cell Mobilization/statistics & numerical data , Hematopoietic Stem Cell Transplantation/trends , Practice Patterns, Physicians'/statistics & numerical data , Procedures and Techniques Utilization/statistics & numerical data , Tissue Preservation/methods , Transplantation, Autologous , Unrelated Donors/statistics & numerical data
Biol Blood Marrow Transplant ; 26(12): 2181-2189, 2020 12.
Article in English | MEDLINE | ID: covidwho-722012


The current COVID-19 pandemic, caused by SARS-CoV-2, has impacted many facets of hematopoietic cell transplantation (HCT) in both developed and developing countries. Realizing the challenges as a result of this pandemic affecting the daily practice of the HCT centers and the recognition of the variability in practice worldwide, the Worldwide Network for Blood and Marrow Transplantation (WBMT) and the Center for International Blood and Marrow Transplant Research's (CIBMTR) Health Services and International Studies Committee have jointly produced an expert opinion statement as a general guide to deal with certain aspects of HCT, including diagnostics for SARS-CoV-2 in HCT recipient, pre- and post-HCT management, donor issues, medical tourism, and facilities management. During these crucial times, which may last for months or years, the HCT community must reorganize to proceed with transplantation activity in those patients who urgently require it, albeit with extreme caution. This shared knowledge may be of value to the HCT community in the absence of high-quality evidence-based medicine. © 2020 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc.

Bone Marrow Transplantation , COVID-19/diagnosis , COVID-19/therapy , Hematopoietic Stem Cell Transplantation , SARS-CoV-2 , COVID-19/epidemiology , Humans