The boy had tested positive for the new coronavirus in March, with the whole family, both mom and dad. To facilitate the elimination of Sars-CoV-2, he had been admitted to the Covid Center in Palidoro and compassionately underwent plasma treatment obtained from a Covid-19 patient. Once negative, it was possible to perform the expected transplant with the hematopoietic stem cells taken from his father, who in the meantime had also recovered from the virus.
“It is the demonstration of how the collaboration between centers of excellence in the Lazio region, based on scrupulous respect for correct clinical and scientific procedures, allows to obtain the most effective answers for patients even in times of pandemic”, is the reflection of Franco Locatelli, director of the Department of oncohematology and cell and gene therapy of the Child Jesus and professor of Pediatrics at the Sapienza University of Rome.
The child was infused with the hematopoietic stem cells of the father, chosen as a donor, specially manipulated to eliminate the alpha / beta + T lymphocytes, cells dangerous for the recipient’s organism. This is the technique developed by the Locatelli team and developed in the pediatric hospital of the Holy See with the largest case studies in the world: about 700 parent transplants to date on children with leukemia and blood cancers. “I want to personally thank the colleagues from the Spallanzani hospital, in particular Giuseppe Ippolito, and the colleagues from the San Camillo hospital, with whom we are pleased to share this positive result”, concludes Locatelli.
Now the baby is fine, they say from the hospital, he has had no complications and will undergo normal post-transplant checks. In October 2019, the family arrived in Italy from London, where it lives, to treat the Child Jesus a recurrence of the disease from which the child is affected. To cope with acute lymphoblastic leukemia, a bone marrow transplant is needed and the team of the Department of oncohematology and cell and gene therapy starts the preparatory therapy program: the child undergoes chemo and immunotherapy to lower the ‘charge’ of the disease up to the threshold that allows the transplant to have the best chance of success.
In the months home care and hospital treatments alternate, the treatments produce the desired effect and the moment of transplantation is approaching. Not having found a compatible donor, it was decided to proceed with the transplantation of hematopoietic stem cells as a parent. In March 2020, in the midst of a pandemic, parents underwent the necessary investigations to determine who will be the candidate for bone marrow donation. Covid-19 screening is also planned. And the whole family is positive: asymptomatic dad and son, mom with mild symptoms. To proceed with the transplant it is necessary to wait for everyone to be negative, in particular the child who has immune defenses already compromised by leukemia.
At the same time, it is necessary to respect the intervention program to avoid a new recurrence of the tumor. With hyperimmune plasma, attempts are made to give the child extra ‘weapons’ to eliminate viruses and reduce the risk of complications induced by infection, by circulating a charge of ‘strong’ antibodies. Obtained the OK for compassionate use from the Ethical Committee of the Child Jesus and the go-ahead from the Regional Blood Center, the treatment starts on 9 May in the Covid Center of Palidoro.
The treatment was made possible in collaboration with the Spallanzani hospital (for the recruitment of the plasma donor with the best neutralizing antibody titer) and the San Camillo hospital (for the collection of plasma by apheresis, inactivation – procedure with which they are blocked any pathogens present – and freezing). In the meantime, even the father, the chosen bone marrow donor, is finally negative on the swab and everything is ready for the last checks before the transplant, which takes place on May 29, at the site of the Bambino Gesù del Gianicolo.
Dad’s stem cells are infused to the child, specially manipulated to eliminate T alpha / beta + lymphocytes, cells dangerous for the recipient’s organism. The baby is now “in excellent general condition, has had no post-transplant complications, dad’s cells are multiplying and is on the way to complete recovery,” say from the Child Jesus. The percentage of healing with bone marrow transplantation from one of the 2 parents can now be superimposed on that obtained using a perfectly suitable donor.