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

Area of Science:

• Hematology
• Infectious Diseases
• Oncology

Background:

• Concomitant acute lymphoblastic leukemia (ALL) and COVID-19 presents significant management challenges.
• Treatment strategies require careful consideration of both the hematologic malignancy and the viral infection.

Observation:

• A 40-year-old male with relapsed B-common ALL developed SARS-CoV-2 before initiating inotuzumab therapy.
• Initial inotuzumab administration was followed by remdesivir prophylaxis, but respiratory worsening necessitated a delay in subsequent doses.

Findings:

• Despite an incomplete inotuzumab cycle, the patient achieved complete hematologic remission.
• The patient spontaneously developed anti-SARS-CoV-2 antibodies, and COVID-19 treatment with convalescent plasma led to viral load negativization.

Implications:

• This case suggests that even interrupted ALL treatment regimens may lead to remission.
• Successful management involved a multidisciplinary approach, integrating oncology and infectious disease protocols.
• The patient later received a full inotuzumab cycle, underwent allogeneic transplantation, and achieved sustained remission.