Did COVID-19 impact unrelated donor product delivery for HCT?
Published data offers a glimpse into the early impacts of COVID-19
The toll the COVID-19 pandemic has taken on our society has been well documented. However, the pandemic's effects on the transplant and cell therapy community-including transplant centers, donor registries, donor centers, apheresis and collection centers, donors and patients-have not been well defined until recently.
A manuscript published in Transplantation and Cellular Therapy offers the first report on the impact of the COVID-19 pandemic on the ability of the National Marrow Donor Program® (NMDPSM) and our Network to safely deliver unrelated donor products early in the pandemic. The authors found that the NMDP and Network partners continued to effectively deliver domestic and unrelated donor products to allogeneic transplant patients in similar or shorter timeframes than before COVID-19, despite the many unexpected challenges brought about by the pandemic.
Data analysis - March through May 2020
The authors analyzed data from the NMDP from March through May 2020. They compared it to data from the three months prior to the pandemic (December 2019 through February 2020) and data from the same three months from one year prior (March through May 2019).
They reviewed a number of measures the NMDP and our Network partners implemented rapidly to ensure the worldwide collection and delivery of unrelated donor products continued despite the challenges COVID-19 presented. They reported on data for:
- Preliminary and formal unrelated donor search volume and donor availability
- Acute vs non-acute disease transplant indications
- Courier use and performance
- Conversion rates (formal donor search and workup to cell collection and shipment)
Impact of COVID-19 on donor search, cell collection and cell delivery
The authors found that in the early months of the COVID-19 pandemic, transplant centers submitted fewer preliminary and formal search requests for both domestic and international searches. However, at domestic transplant centers, unrelated donor graft infusion decreased by only 4% when compared to the same time period one year prior.
In addition, they noted an increase in the number of formal searches for patients who had acute diseases, such as acute myeloid leukemia, acute lymphoblastic leukemia and myelodysplastic syndromes. This is in line with guidance from the American Society of Transplantation and Cellular Therapy and the European Society for Blood and Marrow Transplantation, which recommended prioritizing transplant for patients with acute diseases over non-acute diseases.
Despite major logistical challenges, they found that the NMDP completed more than 1,600 transports-including 2,800 transport legs-during the March through May 2020 timeframe. It is important to note that only one product did not meet the requested timeframe, but all products were delivered prior to the initiation of the preparatory regimen.
While donor availability was lower during this timeframe, the NMDP also received more requests for multiple unrelated donors (the NMDP recommended identifying a backup donor) as well as direct to workup requests. This likely impacted the reduced donor availability.
"One of our most important findings was that NMDP conversion rates from formal search to infusion remained close to the same or higher than before the pandemic and they occurred in similar or shorter timeframes. This shows us that our operations functioned effectively-despite continued change-so we could still deliver unrelated donor product for patients in need," shared Steven Devine, MD, Chief Medical Officer, NMDP, and Associate Scientific Director, CIBMTR® (Center for International Blood and Marrow Transplant®).
"Our partners at transplant centers, donor centers, apheresis centers, collection centers, international registries and cord blood banks have overcome tremendous obstacles and quickly adapted their processes so patients could continue to receive life-saving products. The resiliency of our entire Network has been remarkable," Dr. Devine said, concluding, "It's important to remember that none of this would have been possible without the thousands of donors around the world who said 'yes' when called during a pandemic. They are true heroes for our patients."
Access the full manuscript:
Jeffrey Auletta, MD, Division of Pediatric Hematology/Oncology/BMT, Nationwide Children's Hospital and The Ohio State University Comprehensive Cancer Center, Dr. Devine and many members of the NMDP team collaborated on the manuscript.