The COVID-19 pandemic has significantly impacted the delivery of cellular therapeutics, including chimeric antigen receptor (CAR) T cells. This impact has extended beyond patient care to include logistics, administration, and distribution of increasingly limited health care resources. Based on the collective experience of the CAR T-cell Consortium investigators, we review and address several questions and concerns regarding cellular therapy administration in the setting of COVID-19 and make general recommendations to address these issues. Specifically we address: 1) necessary resources for safe administration of cell therapies; 2) determinants of cell therapy utilization; 3) selection among patients with B-cell non-Hodgkin lymphomas and 4) B-cell acute lymphocytic leukemia; 5) supportive measures during cell therapy administration; 6) use and prioritization of tocilizumab, and 7) collaborative care with referring physicians. These recommendations were carefully formulated with the understanding that resources allocation is of the utmost importance and the decision to proceed with CAR T cell therapy will require extensive discussion of potential risks and benefits. Though these recommendations are fluid, at this time it is our opinion that the COVID-19 pandemic should not serve as reason to defer CAR T cell therapy for patients truly in need of a potentially curative therapy.
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation. 2020 Apr 13 [Epub ahead of print]
Veronika Bachanova, Michael R Bishop, Parastoo Dahi, Bhagirathbhai Dholaria, Stephan A Grupp, Brandon Hayes-Lattin, Murali Janakiram, Richard T Maziarz, Joseph P McGuirk, Loretta J Nastoupil, Olalekan O Oluwole, Miguel-Angel Perales, David L Porter, Peter A Riedell
University of Minnesota, Minneapolis, MN., Hematopoietic Cellular Therapy Program, Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, IL., Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY., Vanderbilt-Ingram Cancer Center, Nashville, TN., Children's Hospital of Philadelphia, Philadelphia, PA., Knight Cancer Institute, Oregon Health & Science University, Portland, OR., University of Kansas Cancer Center, Westwood, KS., The University of Texas MD Anderson Cancer Center, Houston, TX., University of Pennsylvania and Abramson Cancer Center, Philadelphia, PA. Electronic address: ., Hematopoietic Cellular Therapy Program, Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, IL. Electronic address: .