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A Rare Case of Hairy Cell Leukemia with Unusual Loss of CD123 Associated with COVID-19 at the Time of Presentation.
Kohla, Samah; Ibrahim, Feryal A; Aldapt, Mahmood B; ELSabah, Hesham; Mohamed, Shehab; Youssef, Reda.
  • Kohla S; Department of Lab Medicine and Pathology, Hematology Division, Hamad Medical Corporation, Doha, Qatar.
  • Ibrahim FA; Department of Clinical Pathology, Hematology Division, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
  • Aldapt MB; Weill Cornell Medicine, Doha, Qatar.
  • ELSabah H; Department of Lab Medicine and Pathology, Hematology Division, Hamad Medical Corporation, Doha, Qatar.
  • Mohamed S; Department of Hematology-Oncology, Hamad Medical Corporation, Doha, Qatar.
  • Youssef R; Department of Hematology-Oncology, Hamad Medical Corporation, Doha, Qatar.
Case Rep Oncol ; 13(3): 1430-1440, 2020.
Article in English | MEDLINE | ID: covidwho-992125
ABSTRACT
Coronavirus disease 2019 (COVID-19) pandemic has been a serious threat and has been reported with different presentations and complications. Older age, along with comorbidities such as diabetes, hypertension, or cardiac disease, increases the risk factors for COVID-19 severity and death [N Engl J Med. 2020;382(18)1708-20 and Lancet Respir Med. 2020 05;8(5)475-81]. It is proposed that cancer patients have a significantly higher incidence of severe incidents including admission to the intensive care unit, the necessity for assisted ventilation, and even death after catching the virus compared with non-cancer patients [Lancet Oncol. 2020;21(3)335-7]. It is also described that cancer patients appear to be twice as likely to contract infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) [JAMA Oncol. 2020;6(7)1108-10]. Hairy cell leukemia (HCL) is a rare B-cell lymphoproliferative disorder, with patients typically presenting with cytopenias, marked splenomegaly in 80-90% of patients, circulating leukemia cells, bone marrow infiltration and the presence of BRAF V600E somatic mutation [Indian J Hematol Blood Transfus. 2014;30(Suppl 1)413-7]. Leukemic cells classically have central nuclei and abundant cytoplasm with hairy-like projections and express CD11c, CD25, CD103, and CD123 [Indian J Hematol Blood Transfus. 2014;30(Suppl 1)413-7]. Loss of CD123 in HCL has been rarely reported in the literature [Am J Hematol. 2019;94(12)1413-22]. We describe a unique case of a COVID-19-positive male who presented with severe respiratory symptoms, deteriorated quickly, and was intubated. Workup of severe progressive pancytopenia and bone marrow examination revealed HCL without splenomegaly and with atypical unusual loss of CD123. To our knowledge, this is the first case of CD123-negative HCL without splenomegaly associated with COVID-19 infection as the initial presentation.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Observational study / Prognostic study Language: English Journal: Case Rep Oncol Year: 2020 Document Type: Article Affiliation country: 000512830

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Observational study / Prognostic study Language: English Journal: Case Rep Oncol Year: 2020 Document Type: Article Affiliation country: 000512830