American Society for Transplantation and Cellular Therapy Pharmacy Special Interest Group Position Statement on Pharmacy Practice Management and Clinical Management for COVID-19 in Hematopoietic Cell Transplant and Cellular Therapy Patients in the United States

Mahmoudjafari, Zahra; Alexander, Maurice; Roddy, Julianna; Shaw, Ryan; Shigle, Terri Lynn; Timlin, Colleen; Culos, Katie

The coronavirus-19 (COVID-19) pandemic poses a significant risk to patients undergoing hematopoietic stem cell transplant or cellular therapy. The American Society for Transplantation and Cellular Therapy Pharmacy Special Interest Group Steering Committee aims to provide pharmacy practice management recommendations for how to transition clinical hematopoietic stem cell transplant (HCT) or cellular therapy pharmacy services utilizing telemedicine capabilities in the inpatient and outpatient setting to maintain an equivalent level of clinical practice but minimizing viral spread in a high risk, immunocompromised population. Additionally, the Steering Committee offers clinical management recommendations for COVID-19 in HCT and cellular therapy patients based on the rapidly developing literature. As the therapeutic and supportive care interventions for COVID-19 increase, collaboration with clinical pharmacy providers is critical to ensure safe administration in HCT patients. Attention to drug-drug interactions (DDI) and toxicity, particularly QTc prolongation, warrants close cardiac monitoring and potential cessation of concomitant QTc prolonging agents. Expanded indications for hydroxychloroquine and tocilizumab have already shown potential stress to usual supply chain. Detailed prescribing algorithms, decision pathways and specific patient population stock may be necessary. The COVID-19 pandemic has challenged every member of the healthcare team and we must continue to remain vigilant in providing pharmacy clinical services to one of the most high-risk patient populations and remain committed to providing compassionate and safe care for patients receiving HCT and cellular therapies.