Viral Clearance with Neutrophil Recovery in a Patient with Active COVID-19 Infection and Refractory Acute Myeloid Leukemia Who Underwent Successful Reinduction with Cytarabine/Idarubicin
Abstract Administering myelosuppressive chemotherapy to patients with aggressive malignant hematologic disorders typically poses serious infectious complications, which can be exacerbated by the presence of active COVID-19 infection. We report on a case of a successfully treated fit elderly woman wi...
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| Veröffentlicht in: | Case Reports in Oncology 2022-08, Vol.15 (2), p.705-712 |
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| container_title | Case Reports in Oncology |
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| creator | Dean, Erin A. Brown, Randy A. Kaur, Pavneet Casaus, Danielle V. |
| description | Abstract
Administering myelosuppressive chemotherapy to patients with aggressive malignant hematologic disorders typically poses serious infectious complications, which can be exacerbated by the presence of active COVID-19 infection. We report on a case of a successfully treated fit elderly woman with refractory acute myeloid leukemia (AML) who also had mild COVID-19 infection and detectable viral load at the time she was found to have recurrent disease. Prior to initiation of reinduction treatment with cytarabine/idarubicin, this 2-dose COVID-19-vaccinated patient received antiviral therapy with remdesivir with resolution of upper respiratory symptoms. This was followed by sotrovimab on the third day of chemotherapy. Throughout her hospital course, she remained hemodynamically stable with one episode of neutropenic fever without other identified infections. Symptomatic reactivation of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing COVID-19 was not observed. After achieving biopsy-confirmed morphologic remission of AML and with neutrophil recovery, the patient gradually cleared the virus, eventually testing negative on polymerase chain reaction test of the nasopharynx. This case underlines the importance of considering initiation of timely chemotherapy, although myelosuppressive, in appropriate patients with aggressive hematologic malignancies and concomitant SARS-CoV-2. It demonstrates management of active COVID-19 infection in this group of patients and the dynamics of SARS-CoV-2 viral load during leukemia treatment. |
| doi_str_mv | 10.1159/000525766 |
| format | Article |
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Administering myelosuppressive chemotherapy to patients with aggressive malignant hematologic disorders typically poses serious infectious complications, which can be exacerbated by the presence of active COVID-19 infection. We report on a case of a successfully treated fit elderly woman with refractory acute myeloid leukemia (AML) who also had mild COVID-19 infection and detectable viral load at the time she was found to have recurrent disease. Prior to initiation of reinduction treatment with cytarabine/idarubicin, this 2-dose COVID-19-vaccinated patient received antiviral therapy with remdesivir with resolution of upper respiratory symptoms. This was followed by sotrovimab on the third day of chemotherapy. Throughout her hospital course, she remained hemodynamically stable with one episode of neutropenic fever without other identified infections. Symptomatic reactivation of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing COVID-19 was not observed. After achieving biopsy-confirmed morphologic remission of AML and with neutrophil recovery, the patient gradually cleared the virus, eventually testing negative on polymerase chain reaction test of the nasopharynx. This case underlines the importance of considering initiation of timely chemotherapy, although myelosuppressive, in appropriate patients with aggressive hematologic malignancies and concomitant SARS-CoV-2. It demonstrates management of active COVID-19 infection in this group of patients and the dynamics of SARS-CoV-2 viral load during leukemia treatment.</description><identifier>ISSN: 1662-6575</identifier><identifier>EISSN: 1662-6575</identifier><identifier>DOI: 10.1159/000525766</identifier><identifier>PMID: 36157697</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>active covid-19 infection ; acute myeloid leukemia ; Antiviral drugs ; Asymptomatic ; Biopsy ; Blood ; Bone marrow ; Cancer therapies ; Case Report ; Case reports ; Case studies ; Chemotherapy ; complete remission ; Coronaviruses ; COVID-19 ; Cytarabine ; Disease prevention ; Dosage and administration ; Fever ; Genes ; Idarubicin ; Infections ; Leukemia ; Monoclonal antibodies ; Mutation ; myelosuppressive chemotherapy ; Neutropenia ; Neutrophils ; Patients ; Pneumonia ; Recovery (Medical) ; Remission (Medicine) ; Respiratory system ; Severe acute respiratory syndrome coronavirus 2 ; Tomography ; viral clearance ; Viral infections</subject><ispartof>Case Reports in Oncology, 2022-08, Vol.15 (2), p.705-712</ispartof><rights>2022 The Author(s). Published by S. Karger AG, Basel</rights><rights>COPYRIGHT 2022 S. Karger AG</rights><rights>2022 The Author(s). Published by S. Karger AG, Basel . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the associated terms available at: https://uk.sagepub.com/en-gb/eur/reusing-open-access-and-sage-choice-content</rights><rights>Copyright © 2022 by The Author(s). Published by S. Karger AG, Basel 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c529t-c1d9e0378c759f56049b5ce99415ea4f6c164af6d0b81b26eede7698c7cc0c533</citedby><orcidid>0000-0003-3153-223X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9459561/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9459561/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,27635,27924,27925,53791,53793</link.rule.ids></links><search><creatorcontrib>Dean, Erin A.</creatorcontrib><creatorcontrib>Brown, Randy A.</creatorcontrib><creatorcontrib>Kaur, Pavneet</creatorcontrib><creatorcontrib>Casaus, Danielle V.</creatorcontrib><title>Viral Clearance with Neutrophil Recovery in a Patient with Active COVID-19 Infection and Refractory Acute Myeloid Leukemia Who Underwent Successful Reinduction with Cytarabine/Idarubicin</title><title>Case Reports in Oncology</title><addtitle>Case Rep Oncol</addtitle><description>Abstract
Administering myelosuppressive chemotherapy to patients with aggressive malignant hematologic disorders typically poses serious infectious complications, which can be exacerbated by the presence of active COVID-19 infection. We report on a case of a successfully treated fit elderly woman with refractory acute myeloid leukemia (AML) who also had mild COVID-19 infection and detectable viral load at the time she was found to have recurrent disease. Prior to initiation of reinduction treatment with cytarabine/idarubicin, this 2-dose COVID-19-vaccinated patient received antiviral therapy with remdesivir with resolution of upper respiratory symptoms. This was followed by sotrovimab on the third day of chemotherapy. Throughout her hospital course, she remained hemodynamically stable with one episode of neutropenic fever without other identified infections. Symptomatic reactivation of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing COVID-19 was not observed. After achieving biopsy-confirmed morphologic remission of AML and with neutrophil recovery, the patient gradually cleared the virus, eventually testing negative on polymerase chain reaction test of the nasopharynx. This case underlines the importance of considering initiation of timely chemotherapy, although myelosuppressive, in appropriate patients with aggressive hematologic malignancies and concomitant SARS-CoV-2. It demonstrates management of active COVID-19 infection in this group of patients and the dynamics of SARS-CoV-2 viral load during leukemia treatment.</description><subject>active covid-19 infection</subject><subject>acute myeloid leukemia</subject><subject>Antiviral drugs</subject><subject>Asymptomatic</subject><subject>Biopsy</subject><subject>Blood</subject><subject>Bone marrow</subject><subject>Cancer therapies</subject><subject>Case Report</subject><subject>Case reports</subject><subject>Case studies</subject><subject>Chemotherapy</subject><subject>complete remission</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Cytarabine</subject><subject>Disease prevention</subject><subject>Dosage and administration</subject><subject>Fever</subject><subject>Genes</subject><subject>Idarubicin</subject><subject>Infections</subject><subject>Leukemia</subject><subject>Monoclonal antibodies</subject><subject>Mutation</subject><subject>myelosuppressive chemotherapy</subject><subject>Neutropenia</subject><subject>Neutrophils</subject><subject>Patients</subject><subject>Pneumonia</subject><subject>Recovery (Medical)</subject><subject>Remission (Medicine)</subject><subject>Respiratory system</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Tomography</subject><subject>viral clearance</subject><subject>Viral infections</subject><issn>1662-6575</issn><issn>1662-6575</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>M--</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DOA</sourceid><recordid>eNptks9v0zAUgCMEYmNw4M7BEicO3eIkduILUhV-VSoUDTaOlvP83LpL7c5JNvVf46_DXarCJOSDrefvfX5-dpK8puk5pUxcpGnKMlZy_iQ5pZxnE85K9vSf9UnyouvWacoF4-x5cpJzGnFRnia_r21QLalbVEE5QHJv-xX5hkMf_HZlW3KJ4O8w7Ih1RJHvqrfo-pGaQm_vkNSL69mHCRVk5gzGkI-g0zHRBAW9j6lTGHokX3fYeqvJHIcb3FhFfq08uXIaw_1e-WMAwK4zw_5M6_Qwqh5Oqnd9LK-xDi9mWoWhsWDdy-SZUW2Hrw7zWXL16ePP-stkvvg8q6fzCbBM9BOgWmCalxWUTBjG00I0DFCIgjJUheFAeaEM12lT0SbjiBpjbyIOkALL87NkNnq1V2u5DXajwk56ZeVDwIelVKG30KJkOWZVoxAZ0MIUucjRQEnzDHWeiUZE1_vRtR2aDWqIF4_tfyR9vOPsSi79nRQFi29Ho-DtQRD87YBdL9d-CC7eX2YlLbKqYBWP1PlILVWsyjrjowzi0LHx4B0aG-PTkpY8LwpexYR3YwIE33UBzbEkmsr9H5PHP_a3hBsVlhiOZH25GAm51SZSb_5LHSR_AGHI2pU</recordid><startdate>20220803</startdate><enddate>20220803</enddate><creator>Dean, Erin A.</creator><creator>Brown, Randy A.</creator><creator>Kaur, Pavneet</creator><creator>Casaus, Danielle V.</creator><general>S. 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Administering myelosuppressive chemotherapy to patients with aggressive malignant hematologic disorders typically poses serious infectious complications, which can be exacerbated by the presence of active COVID-19 infection. We report on a case of a successfully treated fit elderly woman with refractory acute myeloid leukemia (AML) who also had mild COVID-19 infection and detectable viral load at the time she was found to have recurrent disease. Prior to initiation of reinduction treatment with cytarabine/idarubicin, this 2-dose COVID-19-vaccinated patient received antiviral therapy with remdesivir with resolution of upper respiratory symptoms. This was followed by sotrovimab on the third day of chemotherapy. Throughout her hospital course, she remained hemodynamically stable with one episode of neutropenic fever without other identified infections. Symptomatic reactivation of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing COVID-19 was not observed. After achieving biopsy-confirmed morphologic remission of AML and with neutrophil recovery, the patient gradually cleared the virus, eventually testing negative on polymerase chain reaction test of the nasopharynx. This case underlines the importance of considering initiation of timely chemotherapy, although myelosuppressive, in appropriate patients with aggressive hematologic malignancies and concomitant SARS-CoV-2. It demonstrates management of active COVID-19 infection in this group of patients and the dynamics of SARS-CoV-2 viral load during leukemia treatment.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>36157697</pmid><doi>10.1159/000525766</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3153-223X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | active covid-19 infection acute myeloid leukemia Antiviral drugs Asymptomatic Biopsy Blood Bone marrow Cancer therapies Case Report Case reports Case studies Chemotherapy complete remission Coronaviruses COVID-19 Cytarabine Disease prevention Dosage and administration Fever Genes Idarubicin Infections Leukemia Monoclonal antibodies Mutation myelosuppressive chemotherapy Neutropenia Neutrophils Patients Pneumonia Recovery (Medical) Remission (Medicine) Respiratory system Severe acute respiratory syndrome coronavirus 2 Tomography viral clearance Viral infections |
| title | Viral Clearance with Neutrophil Recovery in a Patient with Active COVID-19 Infection and Refractory Acute Myeloid Leukemia Who Underwent Successful Reinduction with Cytarabine/Idarubicin |
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