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Blood and marrow transplant within 4 weeks of SARS-CoV-2 infection is associated with increased risk of mortality: a National COVID Cohort Collaborative (N3C) Study

Bone Marrow Transplantation volume 59, pages 121–124 (2024)Cite this article

Subjects

Patients with cancer are increasingly susceptible to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection including a higher risk of developing severe infection [1,2,3]. With widespread infection, it is imperative to understand the clinical outcomes of patients undergoing bone marrow transplant (BMT) after a SARS-CoV2 infection. Currently, the American Society of Transplantation and Cellular Therapy (ASTCT) recommends deferring BMT for 2 weeks following a SARS-CoV-2 infection with consideration for early therapy in asymptomatic infection and delay treatment till clinical recovery or 2–3 weeks from a positive assay in symptomatic infection [4].

The National COVID Cohort Collaborative (N3C) is a large population-based nationwide dataset related to SARS-COV-2 symptoms and patient outcomes in the United States through the National Center for Advancing Translational Sciences of the National Institutes of Health. In this report, we sought to characterize patients with primary hematological cancer who underwent BMT after a SARS-CoV-2 infection and to identify risk factors that contributed to an adverse all-cause mortality within the N3C cohort.

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Fig. 1

Data availability

MM and AK had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Data will be available upon resonable request to corresponding author.

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Acknowledgements

Data Partners with Released Data: The following institutions whose data is released or pending: Available: Advocate Health Care Network—UL1TR002389: The Institute for Translational Medicine (ITM) • Boston University Medical Campus—UL1TR001430: Boston University Clinical and Translational Science Institute • Brown University—U54GM115677: Advance Clinical Translational Research (Advance-CTR) • Carilion Clinic—UL1TR003015: iTHRIV Integrated Translational health Research Institute of Virginia • Charleston Area Medical Center—U54GM104942: West Virginia Clinical and Translational Science Institute (WVCTSI) • Children’s Hospital Colorado—UL1TR002535: Colorado Clinical and Translational Sciences Institute • Columbia University Irving Medical Center—UL1TR001873: Irving Institute for Clinical and Translational Research • Duke University—UL1TR002553: Duke Clinical and Translational Science Institute • George Washington Children’s Research Institute—UL1TR001876: Clinical and Translational Science Institute at Children’s National (CTSA-CN) • George Washington University—UL1TR001876: Clinical and Translational Science Institute at Children’s National (CTSA-CN) • Indiana University School of Medicine—UL1TR002529: Indiana Clinical and Translational Science Institute • Johns Hopkins University—UL1TR003098: Johns Hopkins Institute for Clinical and Translational Research • Loyola Medicine—Loyola University Medical Center • Loyola University Medical Center—UL1TR002389: The Institute for Translational Medicine (ITM) • Maine Medical Center—U54GM115516: Northern New England Clinical & Translational Research (NNE-CTR) Network • Massachusetts General Brigham—UL1TR002541: Harvard Catalyst • Mayo Clinic Rochester—UL1TR002377: Mayo Clinic Center for Clinical and Translational Science (CCaTS) • Medical University of South Carolina—UL1TR001450: South Carolina Clinical & Translational Research Institute (SCTR) • Montefiore Medical Center—UL1TR002556: Institute for Clinical and Translational Research at Einstein and Montefiore • Nemours—U54GM104941: Delaware CTR ACCEL Program • NorthShore University HealthSystem—UL1TR002389: The Institute for Translational Medicine (ITM) • Northwestern University at Chicago—UL1TR001422: Northwestern University Clinical and Translational Science Institute (NUCATS) • OCHIN—INV-018455: Bill and Melinda Gates Foundation grant to Sage Bionetworks • Oregon Health & Science University—UL1TR002369: Oregon Clinical and Translational Research Institute • Penn State Health Milton S. Hershey Medical Center—UL1TR002014: Penn State Clinical and Translational Science Institute • Rush University Medical Center—UL1TR002389: The Institute for Translational Medicine (ITM) • Rutgers, The State University of New Jersey—UL1TR003017: New Jersey Alliance for Clinical and Translational Science • Stony Brook University—U24TR002306 • The Ohio State University—UL1TR002733: Center for Clinical and Translational Science • The State University of New York at Buffalo—UL1TR001412: Clinical and Translational Science Institute • The University of Chicago—UL1TR002389: The Institute for Translational Medicine (ITM) • The University of Iowa—UL1TR002537: Institute for Clinical and Translational Science • The University of Miami Leonard M. Miller School of Medicine—UL1TR002736: University of Miami Clinical and Translational Science Institute • The University of Michigan at Ann Arbor—UL1TR002240: Michigan Institute for Clinical and Health Research • The University of Texas Health Science Center at Houston—UL1TR003167: Center for Clinical and Translational Sciences (CCTS) • The University of Texas Medical Branch at Galveston—UL1TR001439: The Institute for Translational Sciences • The University of Utah—UL1TR002538: Uhealth Center for Clinical and Translational Science • Tufts Medical Center—UL1TR002544: Tufts Clinical and Translational Science Institute • Tulane University—UL1TR003096: Center for Clinical and Translational Science • University Medical Center New Orleans—U54GM104940: Louisiana Clinical and Translational Science (LA CaTS) Center • University of Alabama at Birmingham—UL1TR003096: Center for Clinical and Translational Science • University of Arkansas for Medical Sciences—UL1TR003107: UAMS Translational Research Institute • University of Cincinnati—UL1TR001425: Center for Clinical and Translational Science and Training • University of Colorado Denver, Anschutz Medical Campus—UL1TR002535: Colorado Clinical and Translational Sciences Institute • University of Illinois at Chicago—UL1TR002003: UIC Center for Clinical and Translational Science • University of Kansas Medical Center—UL1TR002366: Frontiers: University of Kansas Clinical and Translational Science Institute • University of Kentucky—UL1TR001998: UK Center for Clinical and Translational Science • University of Massachusetts Medical School Worcester—UL1TR001453: The UMass Center for Clinical and Translational Science (UMCCTS) • University of Minnesota—UL1TR002494: Clinical and Translational Science Institute • University of Mississippi Medical Center—U54GM115428: Mississippi Center for Clinical and Translational Research (CCTR) • University of Nebraska Medical Center—U54GM115458: Great Plains IDeA-Clinical & Translational Research • University of North Carolina at Chapel Hill—UL1TR002489: North Carolina Translational and Clinical Science Institute • University of Oklahoma Health Sciences Center—U54GM104938: Oklahoma Clinical and Translational Science Institute (OCTSI) • University of Rochester—UL1TR002001: UR Clinical & Translational Science Institute • University of Southern California—UL1TR001855: The Southern California Clinical and Translational Science Institute (SC CTSI) • University of Vermont—U54GM115516: Northern New England Clinical & Translational Research (NNE-CTR) Network • University of Virginia—UL1TR003015: iTHRIV Integrated Translational health Research Institute of Virginia • University of Washington—UL1TR002319: Institute of Translational Health Sciences • University of Wisconsin-Madison—UL1TR002373: UW Institute for Clinical and Translational Research • Vanderbilt University Medical Center—UL1TR002243: Vanderbilt Institute for Clinical and Translational Research • Virginia Commonwealth University—UL1TR002649: C. Kenneth and Dianne Wright Center for Clinical and Translational Research • Wake Forest University Health Sciences—UL1TR001420: Wake Forest Clinical and Translational Science Institute • Washington University in St. Louis—UL1TR002345: Institute of Clinical and Translational Sciences • Weill Medical College of Cornell University—UL1TR002384: Weill Cornell Medicine Clinical and Translational Science Center • West Virginia University—U54GM104942: West Virginia Clinical and Translational Science Institute (WVCTSI). Submitted: Icahn School of Medicine at Mount Sinai—UL1TR001433: ConduITS Institute for Translational Sciences • The University of Texas Health Science Center at Tyler—UL1TR003167: Center for Clinical and Translational Sciences (CCTS) • University of California, Davis—UL1TR001860: UCDavis Health Clinical and Translational Science Center • University of California, Irvine—UL1TR001414: The UC Irvine Institute for Clinical and Translational Science (ICTS) • University of California, Los Angeles—UL1TR001881: UCLA Clinical Translational Science Institute • University of California, San Diego—UL1TR001442: Altman Clinical and Translational Research Institute • University of California, San Francisco—UL1TR001872: UCSF Clinical and Translational Science Institute. Pending: Arkansas Children’s Hospital—UL1TR003107: UAMS Translational Research Institute • Baylor College of Medicine—None (Voluntary) • Children’s Hospital of Philadelphia—UL1TR001878: Institute for Translational Medicine and Therapeutics • Cincinnati Children’s Hospital Medical Center—UL1TR001425: Center for Clinical and Translational Science and Training • Emory University—UL1TR002378: Georgia Clinical and Translational Science Alliance • HonorHealth—None (Voluntary) • Loyola University Chicago—UL1TR002389: The Institute for Translational Medicine (ITM) • Medical College of Wisconsin—UL1TR001436: Clinical and Translational Science Institute of Southeast Wisconsin • MedStar Health Research Institute—UL1TR001409: The Georgetown-Howard Universities Center for Clinical and Translational Science (GHUCCTS) • MetroHealth—None (Voluntary) • Montana State University—U54GM115371: American Indian/Alaska Native CTR • NYU Langone Medical Center—UL1TR001445: Langone Health’s Clinical and Translational Science Institute • Ochsner Medical Center—U54GM104940: Louisiana Clinical and Translational Science (LA CaTS) Center • Regenstrief Institute—UL1TR002529: Indiana Clinical and Translational Science Institute • Sanford Research—None (Voluntary) • Stanford University—UL1TR003142: Spectrum: The Stanford Center for Clinical and Translational Research and Education • The Rockefeller University—UL1TR001866: Center for Clinical and Translational Science • The Scripps Research Institute—UL1TR002550: Scripps Research Translational Institute • University of Florida—UL1TR001427: UF Clinical and Translational Science Institute • University of New Mexico Health Sciences Center—UL1TR001449: University of New Mexico Clinical and Translational Science Center • University of Texas Health Science Center at San Antonio—UL1TR002645: Institute for Integration of Medicine and Science • Yale New Haven Hospital—UL1TR001863: Yale Center for Clinical Investigation.

Funding

This work was funded by the Advancing a Healthier Wisconsin Endowment Seed Grant (MM, AK, NV, AS) and Advancing a Healthier Wisconsin Endowment-CTSI KL2 award (MM). The analyses described in this report were conducted with data or tools accessed through the NCATS N3C Data Enclave (https://covid.cd2h.org) and N3C Attribution & Publication Policy v 1.2-2020-08-25b supported by NCATS U24 TR002306. This research was possible because of the patients whose information is included within the data and the organizations (https://ncats.nih.gov/n3c/resources/data-contribution/data-transfer-agreement-signatories) and scientists who have contributed to the on-going development of this community resource.

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  1. These authors contributed equally: Meera Mohan, Anai Kothari

Authors and Affiliations

  1. Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA

    Meera Mohan, Aditya Shreenivas, Sabarinath Venniyil Radhakrishnan, Binod Dhakal, Siegfried Janz, Marcello Pasquini, Mehdi Hamadani & Anita D’Souza

  2. Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA

    Anai Kothari & Nathaniel Verhagen

  3. Division of Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA

    Carlos Figueroa-Castro

  4. Division of Hematology/Oncology, Department of Medicine, Mayo Clinic Arizona, Phoenix, AZ, USA

    Saurabh Chhabra

  5. Division of Biostatistics, Institute of Health and Safety, Medical College of Wisconsin, Milwaukee, WI, USA

    Aniko Szabo

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Consortia

N3C consortium

Contributions

Authorship was determined using ICMJE recommendations. Conception and design: MM, AK, NV, AS, and AD. Provision of study materials or patients: AK and NV. Collection and assembly of data: AK and NV. Data analysis and interpretation: MM, AK, MH, SJ, AS and AD. Manuscript writing: MM, AK, AS and AD. Final approval of manuscript: all authors.

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Correspondence to Meera Mohan.

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Mohan, M., Kothari, A., Verhagen, N. et al. Blood and marrow transplant within 4 weeks of SARS-CoV-2 infection is associated with increased risk of mortality: a National COVID Cohort Collaborative (N3C) Study. Bone Marrow Transplant 59, 121–124 (2024). https://doi.org/10.1038/s41409-023-02096-z

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