Analysis of the survival of patients undergoing Allogeneic Hematopoietic Progenitor Cell Transplantation before and during the COVID-19 Pandemic in a Hospital in Rio de Janeiro
DOI:
https://doi.org/10.32635/2176-9745.RBC.2024v70n3.4733Keywords:
COVID-19, Bone Marrow Transplant, Cryopreservation, SurvivalAbstract
Introduction: The COVID-19 pandemic has changed the dynamics of graft conservation and performance of allogeneic hematopoietic progenitor cell transplantation (HPCT), which may have affected patient survival. Objective: To analyze the survival of patients after immediate post-HPCT (100 days after HPCT) according to exposure to different types of transplants and graft sources, before and during the COVID-19 pandemic. Method: Hospital-based retrospective cohort study with 246 patients who underwent HPCT at a referral hospital in the city of Rio de Janeiro between January 2016 and December 2021. The log-rank and Kaplan-Meier methods were used to estimate the survival functions of immediate post-HPCT. Results: The mortality rate was slightly higher during the pandemic when compared to pre-pandemic (10.1% vs. 8.8%). The graft most utilized throughout the period investigated was bone marrow (BM, 85%). However, during the pandemic, 50.5% of allogeneic collections were performed using mobilized peripheral blood (MPB). Eight percent of cryopreserved grafts were not infused. No differences in survival were observed among patients who used MPB as a graft source compared to BM. Conclusion: Graft types and transplant sources did not influence patient survival in either period. Cryopreservation proved to be an important tool to overcome the logistical challenges associated with the COVID-19 pandemic, however, a relevant percentage of cryopreserved grafts were not used. Therefore, transplantation centers should resume HPCT with fresh products, reducing the percentage of grafts unused.
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