Posted: Wednesday, July 22, 2020
Efforts to illuminate the impact of COVID-19 on pediatric patients with acute myeloid leukemia (AML) has revealed the difficulty of making treatment decisions for these patients, according to a presentation during the American Association for Cancer Research (AACR) Virtual Meeting on COVID-19 and Cancer (Abstract PO-012). “The different serologic response in these patients seems to correlate with the intensity of therapy they received and may have contributed to the overall severity of their COVID-19,” explained Himalee S. Sabnis, MD, of Emory University School of Medicine, Atlanta, and colleagues.
Two pediatric patients with COVID-19 and AML were the focus of the presentation. The authors assessed the patients’ clinical presentation, serology, and treatment. Testing for serial quantitative IgG was performed utilizing enzyme-linked immunosorbent assay to the SARS-CoV-2 spike protein receptor binding domain.
Analysis of the first patient revealed therapy-related AML and a positive COVID-19 diagnosis. The patient was administered remdesivir to treat COVID-19 and modified induction therapy with cytarabine beginning on hospital day 3. His treatment regimen revealed increased SARS-CoV-2 IgG titer levels on day 4, followed by a negative COVID-19 test on day 14. Furthermore, he was given azacitidine and gemtuzumab ozogamicin as myelosuppressive AML therapy beginning on day 26. Currently, on day 34, he is still demonstrating elevated IgG titer levels.
In addition, the second patient demonstrated de novo AML and tested positive for COVID-19. He was administered cytarabine, etoposide, and daunorubicin beginning on hospital day 2. To combat his hypoxemic respiratory failure that began on day 4, he was given convalescent plasma, remdesivir, and tocilizumab. Following treatment, the patient showed decreased SARS-CoV-2 IgG titer levels. His condition has continued to worsen, as he remained positive for COVID-19 on day 21 and is experiencing multiorgan failure as of day 25. However, he is demonstrating signs of neutrophil recovery.
Disclosure: No information regarding conflicts of interest was provided.