![]() ![]() If the drug has decreased transfusion frequency, then continuing treatment would be beneficial in terms of avoiding prolonged clinic visits for transfusions and decreasing utilization of a limited blood supply. If patients are currently taking luspatercept, there are no theoretical reasons to stop treatment. No data are available to date on luspatercept and COVID-19. Luspatercept has been approved for adults with transfusion dependent beta thalassemia and has been shown to significantly reduce transfusion burden in this population. What about treatment with the recently approved disease-modifying drug luspatercept during the COVID-19 pandemic? Patients should be reminded that adherence to the iron chelation dose and schedule recommended by their thalassemia care provider will reduce organ injury and thalassemia complications. Many comorbidities in thalassemia are related to iron overload. If a patient becomes symptomatic, particularly with moderate to severe disease, then interruption of iron chelation is advisable, with ongoing communication between the treating physicians and the hematologist. If a patient is exposed but asymptomatic there is no reason to interrupt iron chelation. No data are available regarding iron chelation and susceptibility to COVID-19 or severity of infection. Should thalassemia patients continue iron chelation if they are exposed to or have confirmed COVID-19 disease? Clinical sites and blood banks should develop contingency plans for adjusting transfusion regimens and obtaining appropriate donor units for individuals with alloimmunization in the event a significant shortage develops. Hematologists and other thalassemia care providers should continue to follow local and national developments related to possible blood shortages related to COVID-19. Clinics and infusion centers should offer patients the safest possible environment for receiving transfusions, in areas free of COVID-19 patients or those being screened for respiratory symptoms and providing health care personnel protective equipment. It is advisable to maintain the individual’s chronic transfusion regimen. Should any changes in transfusion schedules or thresholds be made in the context of the COVID-19 pandemic?Īt present there is no evidence that the SARS-CoV-2 virus may be transmitted through donated blood. ![]() ![]() Splenectomized patients who develop fever should be evaluated for possible bacterial infection and should receive antibiotics to cover secondary bacterial infections. ![]() Splenectomy is not known to increase the general risk of viral infection or severe viral disease, but no specific data exists for SARS-CoV-2. 2022 97:E75-E78) showing a fivefold increase in age-standardized lethality due to SARS-CoV-2 infection. 1 The number of infected thalassemia patients was lower than expected, likely due to earlier and more vigilant self-isolation compared to the general population. An update of Italian data has been recently published ( Am J Hematol. Nonetheless, outcomes were recently reported from a small cohort of Italian patients followed in the northern part of Italy, where the pandemic has been the most widespread, showing most experienced relatively mild to moderate COVID-19 disease. Thus, it seems possible that there could be an increased risk of more severe COVID-19 disease in some patients. Thalassemia patients, especially young adults/adults, have a chronic condition which may be associated with several co-morbidities linked to the underlying disease as well as complications of chronic transfusions, including heart failure, pulmonary hypertension, and diabetes. Note: Please review ASH's disclaimer regarding the use of the following information.Īre patients with thalassemia more susceptible to serious COVID-19 disease? Does splenectomy confer a higher risk? Input from Maria Cappellini, MD Antonio Piga, MD Janet Kwiatkowski, MD and Alexis Thompson, MD. (Version 2.1 last updated January 19, 2022) ![]()
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