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Hematopoietic stem cell transplant in two pediatric patients testing positive for SARS-CoV-2: A case report.
Krajewski, Jennifer; Chen, Jing; Motiani, Juhi; Baer, Aryeh; Appel, Burton; Zakrzewski, Johannes; Hankewycz, Melanie; Durning, Nancy; Gillio, Alfred.
  • Krajewski J; Pediatric Blood and Marrow Transplantation, Hackensack University Medical Center, Hackensack, New Jersey, USA.
  • Chen J; Pediatric Hematology & Oncology, Hackensack University Medical Center, Hackensack, New Jersey, USA.
  • Motiani J; Pediatrics, Hackensack University Medical Center, Hackensack, New Jersey, USA.
  • Baer A; Pediatric Infectious Diseases, Hackensack University Medical Center, Hackensack, New Jersey, USA.
  • Appel B; Pediatric Hematology & Oncology, Hackensack University Medical Center, Hackensack, New Jersey, USA.
  • Zakrzewski J; Pediatric Blood and Marrow Transplantation, Hackensack University Medical Center, Hackensack, New Jersey, USA.
  • Hankewycz M; Pediatric Blood and Marrow Transplantation, Hackensack University Medical Center, Hackensack, New Jersey, USA.
  • Durning N; Pediatric Blood and Marrow Transplantation, Hackensack University Medical Center, Hackensack, New Jersey, USA.
  • Gillio A; Pediatric Blood and Marrow Transplantation, Hackensack University Medical Center, Hackensack, New Jersey, USA.
Pediatr Transplant ; 26(2): e14179, 2022 03.
Article in English | MEDLINE | ID: covidwho-1488242
ABSTRACT

BACKGROUND:

The SARS-CoV-2 pandemic brought challenges to all areas of medicine. In pediatric bone marrow transplant (BMT), one of the biggest challenges was determining how and when to transplant patients infected with SARS-CoV-2 while mitigating the risks of COVID-related complications.

METHODS:

Our joint adult and pediatric BMT program developed protocols for performing BMT during the pandemic, including guidelines for screening and isolation. For patients who tested positive for SARS-CoV-2, the general recommendation was to delay BMT for at least 14 days from the start of infection and until symptoms improved and the patient twice tested negative by polymerase chain reaction (PCR). However, delaying BMT in patients with malignancy increases the risk of relapse.

RESULTS:

We opted to transplant two SARS-CoV-2 persistently PCR positive patients with leukemia at high risk of relapse. One patient passed away early post-BMT of a transplant-related complication. The other patient is currently in remission and doing well.

CONCLUSION:

These cases demonstrate that when the risk associated with delaying BMT is high, it may be reasonable to proceed to transplant in pediatric leukemia patients infected with SARS-CoV-2.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Leukemia, B-Cell / Leukemia, Myeloid, Acute / Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Hematopoietic Stem Cell Transplantation / COVID-19 Type of study: Case report / Diagnostic study / Prognostic study Topics: Long Covid Limits: Adolescent / Female / Humans / Infant / Male Language: English Journal: Pediatr Transplant Journal subject: Pediatrics / Transplantation Year: 2022 Document Type: Article Affiliation country: Petr.14179

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Leukemia, B-Cell / Leukemia, Myeloid, Acute / Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Hematopoietic Stem Cell Transplantation / COVID-19 Type of study: Case report / Diagnostic study / Prognostic study Topics: Long Covid Limits: Adolescent / Female / Humans / Infant / Male Language: English Journal: Pediatr Transplant Journal subject: Pediatrics / Transplantation Year: 2022 Document Type: Article Affiliation country: Petr.14179