Addressing the Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Hematopoietic Cell Transplantation: Learning Networks as a Means for Sharing Best Practices

Abstract

The full impact of the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), on the field of hematopoietic cell transplantation (HCT) is unknown. This perspective paper reviews the following: current COVID-19 epidemiology, diagnosis, and potential therapies; care considerations unique to HCT recipients; and the concept of a learning network to assimilate emerging guidelines and best practices and to optimize patient outcomes through facilitating shared learning and experience across transplantation centers.

Keywords: Bone marrow transplantation; COVID-19; Cell therapy; Coronavirus; Hematopoietic cell transplantation; Immunocompromise; SARS-CoV-2; Severe acute respiratory syndrome.

Figure 1

Presumed risk factors for COVID-19 in HCT recipients. The risk for developing COVID-19 is likely a composite of donor- and recipient-derived factors, underlying disease, and therapy received, in addition to exposure of both donor and recipient to SARS-CoV-2. In addition, factors inherent to the SARS-CoV-2 virus, including transmissibility (R₀), incubation period, and duration of shedding, also confer risk to the immunocompromised patient. UCB, umbilical cord blood.

Figure 2

Proposed holistic care model for patients and healthcare providers during COVID-19. To address the COVID-19 pandemic, a holistic care model is needed that addresses 4 key areas—patients and families, healthcare providers and institutions, government and regulatory agencies, and the industrial and private sectors—through interdependent collaboration. Each focus area must identify and prioritize goals that address basic to advanced needs within and across areas. Finally, 4 key components are needed to ensure functionality of the model: agility to respond to changing needs, consistent and accurate messaging, resource reallocation and repurposing, and an engaged and informed community. HC, healthcare; POC, point of care.

Figure 3

Timeline showing relevant activities of the TALNT, including membership profile and short-term and long-term goals. DUA, data use agreement; GVHD, graft-versus-host disease; IRB, institutional review board; QI, quality improvement.

Figure 4

TALNT survey results and subsequent content shared through an online platform relevant to care model focus areas and goals. (A) TALNT membership survey results. Members were asked to rank which topics would be most helpful for addressing COVID-19. The top 3 topics became the focus for future interaction among the membership. (B) The top 3 topics and their relevance to focus areas and goals of the proposed holistic care model needed to confront the COVID-19 pandemic. Examples of content posted on the online platform are provided, including questions as well as publications.