Management of Relapsed/Refractory All with Inotuzumab During COVID-19. A Case Report

Management of patients with concomitant acute lymphoblastic leukemia (ALL) and COVID-19 infection is challenging. We describe the clinical history of a 40-year-old male with relapsed B-common ALL who developed Sars-CoV2 prior to treatment initiation with inotuzumab. Since the patient was asymptomatic for COVID-19, the first dose of inotuzumab was administered, followed by remdesivir as prophylaxis. However, a worsening in respiratory findings led to a delay in administering the following doses of inotuzumab. Interestingly, even if the patient did not receive the full inotuzumab cycle, he achieved a complete hematologic remission: furthermore, he spontaneously developed anti-sars-COV2 antibodies. COVID-19 treatment also included convalescent plasma, leading to negativization of the viral load. The patient, after COVID-19 recovery, received a second full cycle of inotuzumab, underwent allogeneic transplantation, and is currently in complete hematologic and molecular remission, in good clinical conditions, five months from allograft.

Automated summary

This article describes the clinical history of a patient with concomitant acute lymphoblastic leukemia (ALL) and COVID-19 infection. The patient developed Sars-CoV2 prior to treatment initiation, but was asymptomatic for COVID-19. Despite respiratory findings worsening during treatment, the patient achieved complete hematologic remission without completing the full treatment cycle and spontaneously developed anti-Sars-CoV-2 antibodies. After COVID-19 recovery, the patient underwent transplantation and achieved complete remission.