Case Report: Remdesivir and Convalescent Plasma in a Newly Acute B Lymphoblastic Leukemia Diagnosis With Concomitant Sars-CoV-2 Infection

Giovanni Battista Dell'Isola; Matteo Felicioni; Luigi Ferraro; Ilaria Capolsini; Carla Cerri; Grazia Gurdo; Elena Mastrodicasa; Maria Speranza Massei; Katia Perruccio; Mariangela Brogna; Alessandra Mercuri; Barbara Luciani Pasqua; Paolo Gorello; Maurizio Caniglia; Alberto Verrotti; Francesco Arcioni

doi:10.3389/fped.2021.712603

Case Report: Remdesivir and Convalescent Plasma in a Newly Acute B Lymphoblastic Leukemia Diagnosis With Concomitant Sars-CoV-2 Infection

Front Pediatr. 2021 Aug 2:9:712603. doi: 10.3389/fped.2021.712603. eCollection 2021.

Authors

Giovanni Battista Dell'Isola¹, Matteo Felicioni¹, Luigi Ferraro¹, Ilaria Capolsini², Carla Cerri², Grazia Gurdo², Elena Mastrodicasa², Maria Speranza Massei², Katia Perruccio², Mariangela Brogna², Alessandra Mercuri³, Barbara Luciani Pasqua⁴, Paolo Gorello⁵, Maurizio Caniglia², Alberto Verrotti¹, Francesco Arcioni²

Affiliations

¹ Pediatric Clinic, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy.
² Pediatric Onco-Hematology With Bone Marrow Transplantation Unit, Azienda Ospedaliera di Perugia, Perugia, Italy.
³ Clinic of Infectious Diseases, Department of Medicine, Azienda Ospedaliera di Perugia, University of Perugia, Perugia, Italy.
⁴ Immunohaematology, Transfusion Service and Apheresis, Azienda Ospedaliera di Perugia, Perugia, Italy.
⁵ Department of Chemistry, Biology and Biotechnology, University of Perugia, Perugia, Italy.

Abstract

Introduction: The spread of Covid-19 has worsened the prognosis of oncology patients, interrupting or delaying life-saving therapies and contextually increasing the risk of severe SARS-CoV-2 infections. Acute lymphoblastic leukemia (ALL) is the most frequent cancer in pediatric age and the management of this disease with concomitant SARS-COV-2 infection represents a challenging situation. Case presentation: We present the case of a 6-year-old female newly diagnosed with ALL during a documented SARS-CoV-2 infection. Our patient was admitted 20 days after SARS-CoV-2 detection for evening-rise fever. Laboratory testing showed severe neutropenia while chest x-ray detected moderate pulmonary involvement. Acute lymphoblastic leukemia diagnosis was made through morphological and molecular analysis on bone marrow aspirate. Given the stability of the blood count and clinical conditions, antiviral therapy with Remdesivir and Convalescent Plasma was started before antileukemic treatment, obtaining a rapid resolution of the infection. Conclusion: In our experience, the treatment with Remdesivir and Convalescent Plasma led to a rapid resolution of Sars-Cov-2 infection. Our case did not present any adverse event to the therapy. Thus, this treatment could be considered in patients with malignancies, in order to accelerate the resolution of the infection and begin immunosuppressive treatment safely. Further studies are required to confirm this hypothesis.

Keywords: COVID-19; SARS–CoV−2; convalescent plasma; leukemia; remdesevir.

Publication types

Case Reports