Blood Res.  2021 Sep;56(3):197-207. 10.5045/br.2021.2020181.

Clinical course of COVID-19 in a patient with refractory chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) under ibrutinib therapy: a case report

• Cecyn KZ
• Marques MO
• Rodrigues MA
• Brito FN
• Guimarães Baiocchi OCC

• KMID: 2520613
• DOI: http://doi.org/10.5045/br.2021.2020181

Abstract

No abstract available

Figure

• 

  Fig. 1 Computed tomography scan of the chest on the day of admission and 8 days later. Thick-ness of the interlobular septa in the pulmonary bases is non-specific and is associated with few centrilo--bular nodules, compatible with a nonspecific in-flammatory/infectious process (A). Small amount of fluid in the right pleural cavity and moderate amount on the left as well as restrictive atelectasis with volumetric reduction of the left lower lobe is seen (B).

• 

  Fig. 2 Treatment received by the patient during SARS-CoV-2 infection. Abbreviations: BP, blood pressure; CRP, C reactive protein; Hgb, hemoglobin; HR, heart rate; LDH, lactate dehydrogenase; Lymph, lymphocytes; Mono, monocytes; Neut, neutrophils; Pl, platelet count; RR, respiratory rate; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; SpO2, oxygen saturation; T-max, maximum temperature; WBC, white blood cell count.

• 

  Fig. 3 Clinical course of the patient with SCLL during SARS-CoV-2 infection. Abbreviations: G, CSF granulocyte colony-stimulating factor; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; U, Units.

Reference

1. World Health Organization. 2021. Coronavirus disease (COVID-19) pandemic; 2020. World Health Organization;Geneva, Switzerland: at https://www.who.int/emergencies/diseases/novel-coronavirus-2019. Accessed March 27, 2020.

2. Gong J, Ou J, Qiu X, et al. 2020; A tool to early predict severe corona virus disease 2019 (COVID-19): a multicenter study using the risk nomogram in Wuhan and Guangdong, China. Clin Infect Dis. 71:833–40. DOI: 10.1093/cid/ciaa443. PMID: 32296824. PMCID: PMC7184338.

3. Liang W, Guan W, Chen R, et al. 2020; Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 21:335–7. DOI: 10.1016/S1470-2045(20)30096-6. PMID: 32066541. PMCID: PMC7159000.

4. Xia Y, Jin R, Zhao J, Li W, Shen H. 2020; Risk of COVID-19 for patients with cancer. Lancet Oncol. 21:e180. DOI: 10.1016/S1470-2045(20)30150-9. PMID: 32142622. PMCID: PMC7130057.

5. Peixoto RD, Lopes MSM. 2020; COVID-19 among cancer patients. What we know so far? Braz J Oncol. 16:e-20200002. DOI: 10.5935/2526-8732.20200002.

6. Jin XH, Zheng KI, Pan KH, Xie YP, Zheng MH. 2020; COVID-19 in a patient with chronic lymphocytic leukaemia. Lancet Haematol. 7:e351–2. DOI: 10.1016/S2352-3026(20)30074-0. PMID: 32220344. PMCID: PMC7118537.

7. Paneesha S, Pratt G, Parry H, Moss P. 2020; Covid-19 infection in therapy-naive patients with B-cell chronic lymphocytic leukemia. Leuk Res. 93:106366. DOI: 10.1016/j.leukres.2020.106366. PMID: 32388230. PMCID: PMC7192083.

8. Yu J, Ouyang W, Chua MLK, Xie C. 2020; SARS-CoV-2 transmission in patients with cancer at a tertiary care hospital in Wuhan, China. JAMA Oncol. 6:1108–10. DOI: 10.1001/jamaoncol.2020.0980. PMID: 32211820. PMCID: PMC7097836.

9. Buggy JJ, Elias L. 2012; Bruton tyrosine kinase (BTK) and its role in B-cell malignancy. Int Rev Immunol. 31:119–32. DOI: 10.3109/08830185.2012.664797. PMID: 22449073.

10. Huang C, Wang Y, Li X, et al. 2020; Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 395:497–506. DOI: 10.1016/S0140-6736(20)30183-5. PMID: 31986264. PMCID: PMC7159299.

11. Treon SP, Castillo JJ, Skarbnik AP, et al. 2020; The BTK inhibitor ibrutinib may protect against pulmonary injury in COVID-19-infected patients. Blood. 135:1912–5. DOI: 10.1182/blood.2020006288. PMID: 32302379. PMCID: PMC7243149.

12. Florence JM, Krupa A, Booshehri LM, Davis SA, Matthay MA, Kurdowska AK. 2018; Inhibiting Bruton's tyrosine kinase rescues mice from lethal influenza-induced acute lung injury. Am J Physiol Lung Cell Mol Physiol. 315:L52–8. DOI: 10.1152/ajplung.00047.2018. PMID: 29516781. PMCID: PMC6087894.

13. Krupa A, Fudala R, Florence JM, et al. 2013; Bruton's tyrosine kinase mediates FcgRIIa/Toll-like receptor-4 receptor crosstalk in human neutrophils. Am J Respir Cell Mol Biol. 48:240–9. DOI: 10.1165/rcmb.2012-0039OC. PMID: 23239500. PMCID: PMC3604059.

14. Kurdowska A, Matthay MA, Krupa A, Florence J. 2015; Targeting Bruton's tyrosine kinase has a protective effect in influenza A virus induced acute lung injury. Am J Respir Crit Care Med. 191:A6103.

15. Woyach JA. 2017; How I manage ibrutinib-refractory chronic lymphocytic leukemia. Blood. 129:1270–4. DOI: 10.1182/blood-2016-09-693598. PMID: 28096090. PMCID: PMC5345730.

16. Hampel PJ, Ding W, Call TG, et al. 2019; Rapid disease progression following discontinuation of ibrutinib in patients with chronic lymphocytic leukemia treated in routine clinical practice. Leuk Lymphoma. 60:2712–9. DOI: 10.1080/10428194.2019.1602268. PMID: 31014142. PMCID: PMC6813846.

17. Parikh SA, Achenbach SJ, Call TG, et al. 2020; The impact of dose modification and temporary interruption of ibrutinib on outcomes of chronic lymphocytic leukemia patients in routine clinical practice. Cancer Med. 9:3390–9. DOI: 10.1002/cam4.2998. PMID: 32187452. PMCID: PMC7221301.

18. Scarfò L, Chatzikonstantinou T, Rigolin GM, et al. 2020; COVID-19 severity and mortality in patients with chronic lymphocytic leukemia: a joint study by ERIC, the European Research Initiative on CLL, and CLL Campus. Leukemia. 34:2354–63. DOI: 10.1038/s41375-020-0959-x. PMID: 32647324. PMCID: PMC7347048.