Hematology and Hemotherapy Unit, University Hospital Virgen Macarena, Seville, Spain.
Clinical Oncology Department, University Hospital Virgen Macarena, Seville, Spain.
Front Immunol. 2022 Apr 14;13:860891. doi: 10.3389/fimmu.2022.860891. eCollection 2022.
Immunosuppressant conditions such as hematological malignancies increase the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. It has been described in the literature that patients on anti-CD20 maintenance therapies for lymphoid malignancies are susceptible to having recurrent flares together with viral replication or reinfections, although these cases are scarce. These patients are not well represented in randomized controlled trials, and as a consequence, the evidence for the use of certain treatments in this scenario is lacking. We present two cases of patients with B-cell lymphoma on remission and treated with rituximab on maintenance. They developed at least 1 flare of coronavirus disease 2019 (COVID-19) after acute infection and always after receiving rituximab. RT-PCR was positive in the nasopharyngeal swab and also in plasma. Patients were treated during flares with remdesivir, hyperimmune plasma, and corticosteroids. These two cases showed the unresolved problem of COVID-19 in immunosuppressant patients and showed that despite the vast amount of information available on SARS-CoV-2, information in this subgroup of patients is lacking.
免疫抑制状态，如血液系统恶性肿瘤，会增加严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染的风险。文献中描述了患有淋巴恶性肿瘤的抗 CD20 维持治疗的患者容易出现复发和病毒复制或再感染，尽管这些病例很少见。这些患者在随机对照试验中代表性不足，因此，在这种情况下使用某些治疗方法的证据不足。我们报告了两例缓解期 B 细胞淋巴瘤患者，在维持治疗中使用利妥昔单抗。他们在急性感染后至少有一次新冠肺炎（COVID-19）发作，且总是在接受利妥昔单抗后发作。鼻咽拭子和血浆中的 RT-PCR 均为阳性。在发作期间，患者接受了瑞德西韦、免疫血浆和皮质类固醇治疗。这两例病例表明了免疫抑制患者的 COVID-19 问题仍未得到解决，并且尽管有大量关于 SARS-CoV-2 的信息，但这一亚组患者的信息仍然缺乏。
