Chronic Lymphocytic Leukemia Coverage from Every Angle
Advertisement
Advertisement

COVID-19 and Untreated Patients With CLL: Case Reports Shed Light on Clinical Risks

By: Julia Fiederlein
Posted: Wednesday, May 6, 2020

According to Paul Moss, PhD, of the University of Birmingham, United Kingdom, and colleagues, treatment-naive patients with B-cell chronic lymphocytic leukemia (CLL) who had been infected with COVID-19 showed increased lymphocytosis upon infection—as well as high mortality rates. Generally, COVID-19 infections result in lymphopenia. Four patient profiles, which were published in Leukemia Research, suggest that untreated patients with CLL may be at a higher risk of severe COVID-19 infection than the general public.

The first patient, a 49-year-old man with Binet stage C disease, was admitted with respiratory failure due to COVID-19. By day 3, there was a sixfold increase in white blood cell count to 202 x 109/L (177 lymphocytes). His cell counts eventually returned to baseline, and he recovered.

The second patient was an 81-year-old man with CLL of a CD19+, CD5+ CD23+ phenotype who presented with a cough, fever, common cold symptoms, and an elevated white blood cell count of 37.5 x 109/L (32 lymphocytes). His lymphocyte count increased due to steroid treatments 2 years prior; however, this time it was considerably higher. The patient was diagnosed with COVID-19 and died 4 days later.

The third patient, an 80-year-old woman with Binet stage C disease, presented with shortness of breath and a fever as a result of COVID-19. Upon admission, her lymphocyte count was 253 x 109/, although it reached to 346 x 109/L before she died.

The fourth and final patient was a 79-year-old woman with CLL who had an atypical immunophenotype of CD19+, CD5+/-, CD23+/-, CD79b–, CD10–. She was admitted after experiencing acute respiratory symptoms due to COVID-19. Prior to hospitalization, she had a lymphocyte count of 2.8 x 109/L. Her lymphocyte count rose to 8 x 109/L after infection, and she died shortly after.

“[COVID-induced lymphocytosis] may result from very high levels of endogenous steroids during intense inflammation, but additional mechanisms may be in operation and deserve further investigation,” the investigators commented.

Disclosure: The study authors reported no conflicts of interest.



By continuing to browse this site you permit us and our partners to place identification cookies on your browser and agree to our use of cookies to identify you for marketing. Read our Privacy Policy to learn more.