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Atypical COVID-19 dynamics in a patient with mantle cell lymphoma exposed to rituximab.
Marcacci, Gianpaolo; Fiorentino, Giuseppe; Volzone, Francesco; Falcone, Umberto; Parrella, Roberto; Donnarumma, Daniela; D'Ovidio, Silvia; Annunziata, Anna; Micallo, Giovanni; Portella, Giuseppe; De Chiara, Annarosaria; De Filippi, Rosaria; Crisci, Stefania; Pinto, Antonio.
  • Marcacci G; Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione 'G. Pascale', IRCCS, Naples, Italy.
  • Fiorentino G; Respiratory Physiopathology and Rehabilitation Unit, AORN dei Colli, Naples, Italy.
  • Volzone F; Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione 'G. Pascale', IRCCS, Naples, Italy.
  • Falcone U; Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione 'G. Pascale', IRCCS, Naples, Italy.
  • Parrella R; Respiratory Infectious Disease Unit, AORN dei Colli, Naples, Italy.
  • Donnarumma D; Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione 'G. Pascale', IRCCS, Naples, Italy.
  • D'Ovidio S; Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione 'G. Pascale', IRCCS, Naples, Italy.
  • Annunziata A; Respiratory Physiopathology and Rehabilitation Unit, AORN dei Colli, Naples, Italy.
  • Micallo G; Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione 'G. Pascale', IRCCS, Naples, Italy.
  • Portella G; Department of Translational Medical Sciences, Università degli Studi Federico II, Naples, Italy.
  • De Chiara A; Pathology Unit, Istituto Nazionale Tumori, Fondazione 'G. Pascale', IRCCS, Naples, Italy.
  • De Filippi R; Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione 'G. Pascale', IRCCS, Naples, Italy.
  • Crisci S; Department of Clinical Medicine and Surgery, Università degli Studi Federico II, Naples, Italy.
  • Pinto A; Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione 'G. Pascale', IRCCS, Naples, Italy.
Infect Agent Cancer ; 16(1): 38, 2021 Jun 02.
Article in English | MEDLINE | ID: covidwho-1255945
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
2. Malignant lymphom PROCESS_OF neop
Subject
Malignant lymphom
Predicate
PROCESS_OF
Object
neop
3. Lymphom PROCESS_OF C0030705
Subject
Lymphom
Predicate
PROCESS_OF
Object
C0030705
4. Disease COEXISTS_WITH Lymphom
Subject
Disease
Predicate
COEXISTS_WITH
Object
Lymphom
5. Immunologic Deficiency Syndromes COEXISTS_WITH Lymphom
Subject
Immunologic Deficiency Syndromes
Predicate
COEXISTS_WITH
Object
Lymphom
6. Anti-Antibodies PART_OF 2019 novel coronavirus
Subject
Anti-Antibodies
Predicate
PART_OF
Object
2019 novel coronavirus
7. Lymphom NEG_PROCESS_OF C0030705
Subject
Lymphom
Predicate
NEG_PROCESS_OF
Object
C0030705
8. 2019 novel coronavirus PROCESS_OF Patients
Subject
2019 novel coronavirus
Predicate
PROCESS_OF
Object
Patients
9. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
10. Malignant lymphoma, lymphocytic, intermediate differentiation, diffuse PROCESS_OF Patients
Subject
Malignant lymphoma, lymphocytic, intermediate differentiation, diffuse
Predicate
PROCESS_OF
Object
Patients
11. Lymphoma, Non-Hodgkin PROCESS_OF Patients
Subject
Lymphoma, Non-Hodgkin
Predicate
PROCESS_OF
Object
Patients
12. Disease COEXISTS_WITH Lymphoma, Non-Hodgkin
Subject
Disease
Predicate
COEXISTS_WITH
Object
Lymphoma, Non-Hodgkin
13. Immunologic Deficiency Syndromes COEXISTS_WITH Lymphoma, Non-Hodgkin
Subject
Immunologic Deficiency Syndromes
Predicate
COEXISTS_WITH
Object
Lymphoma, Non-Hodgkin
14. Anti-Antibodies PART_OF 2019 novel coronavirus
Subject
Anti-Antibodies
Predicate
PART_OF
Object
2019 novel coronavirus
15. Lymphoma, Non-Hodgkin NEG_PROCESS_OF Patients
Subject
Lymphoma, Non-Hodgkin
Predicate
NEG_PROCESS_OF
Object
Patients
16. 2019 novel coronavirus PROCESS_OF Patients
Subject
2019 novel coronavirus
Predicate
PROCESS_OF
Object
Patients
ABSTRACT
Patients with non-hodgkin lymphomas (NHL) represent a population of special interest during the current Coronavirus disease-19 (COVID-19) pandemics. NHLs are associated with disease- and treatment-related immunodeficiencies which may generate unusual COVID-19 dynamics and pose unique management challenges. We report the unusual clinical course of COVID-19 in a patient with mantle cell lymphoma (MCL) exposed to nine doses of Rituximab shortly before infection with severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). He had a prolonged asymptomatic phase, with negative molecular and antibody testing for SARS-CoV-2, followed by a rapidly progressive evolution to severe COVID-19. Despite detection of viral RNA overlapped with first symptoms occurrence, anti-SARS-CoV-2 antibodies displayed an asynchronous pattern, with IgG first appearing 2 days after RNA positivity and IgM never being detected throughout the entire clinical course. While disease-associated immune derangements and/or previous treatments involving anti-CD20 antibodies might have contributed to COVID-19 dynamics in our patient, data suggests that antibody testings, without concurrent molecular assessment for SARS-CoV-2, may turn inadequate for monitoring of MCL patients, and in general NHL patients heavily exposed to anti-CD20 antibodies, during the current pandemics. We suggest that repeated molecular testing of nasopharyngeal swab should be implemented in these subjects despite a negative serology and absence of symptoms of SARS-CoV-2 infection. For the same reasons, a customized strategy needs to be developed for patients exposed to anti-CD20 antibodies, based on different features and mechanism of action of available SARS-CoV-2 vaccines and novel vaccinomics developments.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Topics: Vaccines Language: English Journal: Infect Agent Cancer Year: 2021 Document Type: Article Affiliation country: S13027-021-00376-1

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Topics: Vaccines Language: English Journal: Infect Agent Cancer Year: 2021 Document Type: Article Affiliation country: S13027-021-00376-1