Table 2 The algorithm applied at the Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance to guide prioritization of patients for hematopoietic cell transplantation during the initial surge of COVID-19 activity in Washington state.

From: Blood and marrow transplantation during the emerging COVID-19 pandemic: the Seattle approach

Type of transplanted planned

Urgent

Consider delay

Delay

Allogeneic

—High-risk AML in CR1

—AML and ALL > CR1

—Secondary AML

—MDS-EB

—CMML-1 and 2

—High-risk ALL in CR1

—Intermediate-risk AML in MRD-negative CR1, tolerating consolidation

—Standard-risk ALL in MRD-negative CR1, tolerating maintenance or consolidation

—MDS without EB, tolerating transfusions

—Myeloproliferative disorders with low blast count and without evidence of rapid progression, tolerating transfusions

Autologous

—Aggressive lymphoma

 

—Multiple myeloma (consider stem cell collection)

—Low-grade lymphoma

—Autoimmune diseases

  1. This triage process was necessary as initial predictions indicated that locally available healthcare resources would get exhausted, which would have impacted the care for transplant patients.
  2. AML acute myeloid leukemia, ALL acute lymphoblastic leukemia, CR complete remission, MDS myelodysplastic syndrome, EB excess blasts, CMML chronic myelomonocytic leukemia, MRD measurable residual disease.
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