MPN-182: Transfusion in Hematology Patients During the COVID19 Pandemic: A Systematic Review

CONTEXT: The world is dealing with a coronavirus pandemic affecting all aspects of our daily life, especially our healthcare systems. Patients with cancer are found to have poorer outcome and higher death rate, especially those with active hematologic malignancies. Transfusion for cancer or treatment-related anemia is an essential part in the management of hematologic patients. OBJECTIVE: The main objective was to assess, based on an extended review of the literature, the safety of transfusion during the COVID-19 pandemic, for patients, staff, and donors. VIREMIA AND POTENTIAL FOR TRANSFUSION-TRANSMISSION: There have been no reported or suspected cases of transfusion-transmitted COVID-19. Respiratory viruses, like influenza, MERS and SARS, are not known to be transmitted via transfusion. For SARS-CoV-2 infection, RNA was detected in blood in 15-20% of symptomatic patients in two studies conducted in China. Viremia was never reported in any asymptomatic patient. Another study in Korea, identified seven donors as COVID-19 confirmed cases after blood donation. None of the recipients have developed any symptoms related to COVID-19. Repository samples from the donors were tested and SARS-CoV-2 RNA was not detected in any of them. Given this information, coupled with the fact that symptomatic patients should not donate blood, the risk of transfusion-transmission of SARS-CoV-2 remains theoretical. THE RISK OF STAFF AND DONOR EXPOSURE TO COVID-19: The risk is proportional to safety measures implemented by the centers. Precautions should be taken including: questionnaire to screen donors by phone before coming to donation; social distancing; donation by appointment; frequent cleaning for all surfaces and equipment. RECOMMENDATIONS FOR HEMATOLOGY PATIENTS: Patients with hematological malignancies must receive state-of-the-art treatment. Think about possible schedules to reduce hospital visits and treatment toxicities. Consider prophylactic erythropoietin stimulating agents if they are judged safe. Give transfusion only for serious (<7 g/dL) or symptomatic anemia. Implement a well-defined strategy for environmental control. Screen for symptoms.