Table 1 Key components of the BMT program’s response to the COVID-19 pandemic.
From: Blood and marrow transplantation during the emerging COVID-19 pandemic: the Seattle approach
Category of response | Key steps |
|---|---|
Initial rapid response | • Incident command structure established [5] • SARS-CoV-2 PCR testing capacity secured • Point-of entry screening at clinical facilities established • Nonurgent and out-of-region transplants deferred • Hospital no-visitor policy implemented • Telehealth transplant consultations replaced face-to-face visits • Work-from-home policy for nonessential staff implemented |
Operational changes | • Additional inpatient rooms converted to negative pressure • Clinic and triage hours extended to preserve inpatient resources • Videoconference rounding as feasible • Additional back-up physician coverage secured • Staff deemed at higher risk of COVID-19 morbidity reassigned • Biweekly videoconferences with program leadership • Internal memoranda to faculty regularly updated and distributed |
SARS-CoV-2 testing by PCR | • All symptomatic patients • Asymptomatic patients:      • At the start of the pretransplant evaluation      • Before initiating the preparative regimen      • Weekly after HCT until discharge to local physician      • Prior to any procedure |
Prioritization of transplants | • Considered risks related to the underlying malignancy (Table 2) and comorbidity • Prioritized local over out-of-region patients • Generally proceeded with HCT if long-term survival estimate > 20% |
Donor considerations | • Unrelated donors: cryopreserve all products • Related donors: negative SARS-CoV-2 testing within 48 h of start of patient conditioning permitted use of fresh donor product |
Clinical trials | • Temporary pause of all phase 1 and 3 trials • Phase 2 trials with potential benefit to patients continued accrual • Study visits conducted by telehealth • Ancillary studies paused |
