A rationale to prioritise vaccination of HSCT patients against COVID-19
Ce dossier présente un ensemble d'articles concernant la prise en charge des cancers durant la crise sanitaire liée au COVID-19
Patients who are frail or have significant comorbidities are especially susceptible to severe acute respiratory syndrome coronavirus 2 infection, and are more likely to develop severe disease, with a higher risk of death than in the general population. This increased risk is notably true for patients with cancer, including those with haematological malignancies. When such patients receive a haematopoietic stem-cell transplantation (HSCT), either allogeneic or autologous, it is possible that their vulnerability to COVID-19 would increase further because of the profound and long-lasting immunosuppression, as well as specific organ toxicities, induced by these procedures. Unfortunately, data on this issue are scarce, with existing data mostly coming from single-centre studies. Although these studies tend to show a high rate of mortality among HSCT recipients with COVID-19, their lack of robustness and statistical power precludes the drawing of firm conclusions and identifying specific risk factors associated with survival in this context.
In The Lancet Haematology, Akshay Sharma and colleagues report on 318 HSCT recipients (184 allogeneic HSCT and 134 autologous HSCT) across various transplantation centres mainly based in the USA, who were diagnosed with COVID-19 and reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) registry. The insufficiency of robust data from large-scale cohorts in this high-risk population renders the present study of importance for physicians caring for HSCT recipients worldwide.
The Lancet Haematology , commentaire, 2020