ALL-083 ALLogeneic Hematopoietic Stem Cell Transplantation of a R/R T-ALL Patient Given Nelarabine, 3 Weeks Post Moderate COVID-19 Infection in the Local Setting

The COVID-19 pandemic has been a trying period, with an increased risk of infections and post-disease complications in patients with leukemia, particularly transplant candidates. Not enough studies have shown the effects of doing HSCT in recently treated COVID patients, nor the appropriate interval in which transplant can be safely done. We are then presented with a case of Relapsed/Refractory T-cell acute lymphoblastic leukemia (T-cell ALL) in an adult patient, given 2 cycles of Nelarabine in preparation for Allogeneic Hematopoietic Stem Cell Transplantation (HSCT). In the interim of preparing for transplant, he incurred COVID-19 pneumonia that was categorized as moderate. He was immediately admitted for transplant within 3 weeks post-recovery from COVID, with successful engraftment and discharge on the 26th-day post-transplant. Although recent NICE and EMBT guidelines have recommended that transplant for recently recovered moderate or severe COVID-19 should be at minimum 3 months post-recovery, we have seen from this case that it is possible to do HSCT post COVID-19 infection within a shorter interval as recommended. Compared also to patients who were treated pre-pandemic, the protocol and complications experienced post-transplant did not differ from this patient who was treated during the pandemic, recovered from post-COVID pneumonia.