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SARS-COV2 pandemic has caused profound challenges in health care systems worldwide. Patients affected by hematological neoplasms appear to be particularly at risk of developing COVID-19 complications, with unfavorable outcomes.
Here, we present the case of a 57-years-old woman diagnosed with severe COVID-19 pneumonia and concurrent acute myeloid leukemia (AML). At the time of diagnosis, it was decided to postpone leukemia therapy to enable adequate COVID-19 pneumonia treatment. When her conditions related to pneumonia improved, the combination of Azacitidine-Venetoclax was used as first-line treatment instead of conventional intensive chemotherapy. At the end of the first two cycles, the patient showed complete remission, and a post-remission consolidation with allogeneic hematopoietic stem cell transplantation has been planned.
This case suggests that Azacytidine-Venetoclax induction may represent a valid and safe alternative to intensive chemotherapy in the challenging setting of patients with a concomitant diagnosis of AML and severe COVID-19 infection.
|Figure 1. (A) Chest computer tomography (CT) showing SARS-COV2 pneumonia with bilateral patchy ground-glass opacities. (B) After four months from the diagnosis, the Chest CT of the same patient shows almost complete resolution of radiological findings.|
|Figure 2. Full blood count parameters are shown; white blood cell count (WBC, reference range 0.49–5.51 xx109/L), neutrophils (0.02–3.88 x 109/L) and platelets (54–487 x 109/L). Venetoclax + Azacitidine administration, starting from day 20 onwards, is indicated by the blue bar.|