Persistent SARS-CoV-2 infection with multiple clinical relapses in two patients with follicular lymphoma treated with bendamustine and obinutuzumab or rituximab

Infection. 2023 Oct;51(5):1577-1581. doi: 10.1007/s15010-023-02039-2. Epub 2023 Apr 19.

Abstract

Purpose: People with hematologic malignancies have a significantly higher risk of developing severe and protracted forms of SARS-CoV-2 infection compared to immunocompetent patients, regardless of vaccination status.

Results: We describe two cases of prolonged SARS-CoV-2 infection with multiple relapses of COVID-19 pneumonia in patients with follicular lymphoma treated with bendamustine and obinutuzumab or rituximab. The aim is to highlight the complexity of SARS-CoV-2 infection in this fragile group of patients and the necessity of evidence-based strategies to treat them properly.

Conclusions: Patients with hematological malignancies treated with bendamustine and anti-CD20 antibodies had a significant risk of prolonged and relapsing course of COVID-19. Specific preventive and therapeutic strategies should be developed for this group of patients.

Keywords: Anti-CD20; Bendamustine; COVID-19; Immunosuppressed patient; Lymphoma; Obinutuzumab; Rituximab; SARS-CoV-2.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bendamustine Hydrochloride / therapeutic use
  • COVID-19*
  • Hematologic Neoplasms* / drug therapy
  • Humans
  • Lymphoma, Follicular* / complications
  • Lymphoma, Follicular* / drug therapy
  • Lymphoma, Follicular* / pathology
  • Neoplasm Recurrence, Local / drug therapy
  • Rituximab / therapeutic use
  • SARS-CoV-2

Substances

  • Rituximab
  • Bendamustine Hydrochloride
  • obinutuzumab