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EBMT 2021 | Managing transplant patients during the COVID-19 pandemic

Christian Chabannon, MD, PhD, Institut Paoli Calmettes, Marseille, France, discusses the use of immunotherapies during the COVID-19 pandemic. Prof. Chabannon outlines why patients being treated with immunotherapies are more likely to develop severe COVID-19 infections, with patients undergoing transplantation being particularly vulnerable to severe infection due to high levels of immunosuppression. Prof. Chabannon then highlights recommendations from EBMT for the care of patients who are undergoing transplantation. This interview took place during the 47th Annual Meeting of the European Group for Blood and Marrow Transplantation (EBMT) 2021.

Transcript (edited for clarity)

It’s now very clear that our patients are at risk of developing more severe forms of the COVID-19 disease, and this is the result of several risk factors. The disease itself in many cases weakens the immune system of our patients. This is very clear, for example, in patients who are treated for lymphoid malignancies, including multiple myeloma.

It’s the treatments that we use, and especially the high-dose steroids regimens that we use in many of those diseases, also contribute to the immune suppression that make the infection more severe in our patients, and especially the transplant patients are highly immunosuppressed, especially the recipients of allogeneic transplantation...

It’s now very clear that our patients are at risk of developing more severe forms of the COVID-19 disease, and this is the result of several risk factors. The disease itself in many cases weakens the immune system of our patients. This is very clear, for example, in patients who are treated for lymphoid malignancies, including multiple myeloma.

It’s the treatments that we use, and especially the high-dose steroids regimens that we use in many of those diseases, also contribute to the immune suppression that make the infection more severe in our patients, and especially the transplant patients are highly immunosuppressed, especially the recipients of allogeneic transplantation. So, it’s quite important that we change our medical practices in order to take advantage of every measure that can efficiently protect patients and patients’ families, including donors, of getting infected with SARS-CoV-2.

EBMT has produced repeatedly recommendations to care for our patients and their relatives in the COVID-19 era. Social distancing is probably key to keep patients and families away from the virus, and vaccination may offer some hopes that we can mitigate or prevent the infection in the near future, but we still need to gain more experience in this field to fully measure how this can change the outcome of the infection when it happens in our patients.

But in anyways, the key word is danger. We want to avoid as much as possible that transplant candidates or already transplanted patients get infected with the SARS-CoV-2 virus.

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Disclosures

Prof. Christian Chabannon, MD, PhD, has participated in consultancy work or speakers bureaus for Kite/Gilead, Novartis, BMS/Celgene, Janssen, Bellicum Pharmaceuticals, BlueBirdBio, Sanofi SA and Terumo BCT.