Abstract:
The global pandemic has resulted in the common occurrence of SARS-CoV-2 infection in the population. In the post-pandemic era, it is imperative to understand the influence of donor SARS-CoV-2 infection on outcomes after allogeneic haematopoietic stem cell transplantation (allo-HSCT). We retrospectively analysed allo-HSCTs from donors with mild SARS-CoV-2 infection or early recovery stage (ERS) (group 1, n = 65) and late recovery stage (group 2, n = 120). Additionally, we included allo-HSCT from donors without prior SARS-CoV-2 infection as group 0 (n = 194). Transplants from donors with different SARS-CoV-2 infection status had comparable primary engraftment and survival rates. However, group 1 had higher incidences of acute graft-versus-host disease (aGvHD), grade II-IV (41.5% vs. 28.1% in group 0 [p = 0.014] and 30.6% in group 2 [p = 0.067]) and grade III-IV (22.2% vs. 9.6% [p = 0.004] in group 0 and 12.2% in group 2 [p = 0.049]). Conversely, the risk of aGvHD in group 2 was similar to that in group 0 (p > 0.5). Multivariable analysis identified group 1 associated with grade II-IV (hazard ratio [HR] 2.307, p = 0.010) and grade III-IV (HR 2.962, p = 0.001) aGvHD, which yielded no significant risk factors for survival. In conclusion, we preliminarily demonstrated donors in the active infection state or ERS of mild SARS-CoV-2 infection were associated with higher incidences of aGvHD in transplants from related donors.
摘要:
全球大流行导致了人群中SARS-CoV-2感染的普遍发生。在后大流行时代,必须了解供体SARS-CoV-2感染对异基因造血干细胞移植(allo-HSCT)后结局的影响。我们回顾性分析了来自轻度SARS-CoV-2感染或早期恢复期(ERS)(第1组,n=65)和晚期恢复期(第2组,n=120)的供体的allo-HSCT。此外,我们将来自先前没有SARS-CoV-2感染的供体的allo-HSCT作为第0组(n=194)。来自具有不同SARS-CoV-2感染状态的供体的移植具有可比的初次植入和存活率。然而,第1组急性移植物抗宿主病(aGvHD)的发生率较高,II-IV级(41.5%与第0组28.1%[p=0.014]和第2组30.6%[p=0.067])和III-IV级(22.2%vs.0组中为9.6%[p=0.004],2组中为12.2%[p=0.049])。相反,第2组的aGvHD风险与第0组相似(p>0.5).多变量分析确定了与II-IV级(风险比[HR]2.307,p=0.010)和III-IV级(HR2.962,p=0.001)aGvHD相关的第1组,没有显著的生存风险因素。总之,我们初步证明了处于活跃感染状态或轻度SARS-CoV-2感染ERS的供体与相关供体移植中aGvHD的发生率较高相关。