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. 2022 Aug 18;140(7):673-684.
doi: 10.1182/blood.2022016089.

How I treat and prevent COVID-19 in patients with hematologic malignancies and recipients of cellular therapies

Firas El Chaer  1 , Jeffery J Auletta  2   3 , Roy F Chemaly  4
Affiliations

How I treat and prevent COVID-19 in patients with hematologic malignancies and recipients of cellular therapies

Firas El Chaer et al. Blood. .

Abstract

Patients with hematologic malignancies and recipients of hematopoietic cell transplantation (HCT) are more likely to experience severe coronavirus disease 2019 (COVID-19) and have a higher risk of morbidity and mortality after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Compared with the general population, these patients have suboptimal humoral responses to COVID-19 vaccines and subsequently increased risk for breakthrough infections, underscoring the need for additional therapies, including pre- and postexposure prophylaxis, to attenuate clinical progression to severe COVID-19. Therapies for COVID-19 are mostly available for adults and in the inpatient and outpatient settings. Selection and administration of the best treatment options are based on host factors; virus factors, including circulating SARS-CoV-2 variants; and therapeutic considerations, including the clinical efficacy, availability, and practicality of treatment and its associated side effects, including drug-drug interactions. In this paper, we discuss how we approach managing COVID-19 in patients with hematologic malignancies and recipients of HCT and cell therapy.

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Figures

None
Graphical abstract
Figure 1.
Figure 1.
Therapeutic agents to prevent and treat COVID-19.
Algorithm.
Algorithm.
Treatment of COVID-19 in patients with hematologic malignancies and recipients of cellular therapies. CPK, creatine phosphokinase; CRP, C-reactive protein; ECMO, extracorporeal membrane oxygenation; LDH, lactate dehydrogenase; PO, by mouth.
Figure 2.
Figure 2.
Managing immunosuppressants in the setting of nirmatrelvir and ritonavir use. JAK, Janus kinase; PRN, pro re nata (as needed).
See this image and copyright information in PMC

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