Reactions 1871, p270 - 4 Sep 2021
Multiple drugs S COVID-19: case report
A 74-year-old woman developed COVID-19 during immunochemotherapy with cyclophosphamide, prednisone, rituximab and vincristine for follicular lymphoma.
The woman presented with a 2-month history of an enlargement of the right palatine tonsil and difficulties with swallowing. In May 2020, she was referred to a laryngologist, and subsequently, a right-side tonsillectomy was performed. In July 2020, she was hospitalised for the evaluation of the disease. She had a history of hypothyroidism, glaucoma, arterial hypertension and hyperuricaemia. She also underwent radical, right-side nephrectomy 25 years previously because of a kidney tumour. She had no family history of neoplasms. No known drug allergies or use of any psychoactive substances was reported. On admission, she was diagnosed with follicular lymphoma. Subsequently, she started receiving immunochemotherapy as per the R-CVP protocol, which included rituximab 375 mg/m2, cyclophosphamide 1200mg, vincristine 1mg and prednisone 10mg [routes not stated]. After the third cycle of therapy (at home), she developed excessive fatigue, nausea and loss of appetite, which deteriorated over the past week. During the next hospitalisation, her physical condition weakened. In view of the current epidemiological situation, a nasopharyngeal swab to test for SARS-CoV-2 was performed on 1 October 2020, which showed positive results. Therefore, a diagnosis of SARS-CoV-2 infection (COVID-19) was confirmed.
Hence, the woman’s immunotherapy with cyclophosphamide, prednisone and vincristine was stopped, while rituximab was continued. Despite the implementation of immunotherapy, she remained asymptomatic for fever and typical pulmonary symptoms of COVID-19. Her general state also improved, and she was discharged from the hospital for self-isolation. After seronegative status, she successfully received six cycles of the RCVP regimen. The PET-CT scan confirmed the complete remission. Hence, maintenance treatment with rituximab monotherapy was initiated, and she received two injections of rituximab.
Lacki S, et al. Low symptomatic COVID-19 in an elderly patient with follicular lymphoma treated with rituximab-based immunotherapy: A case report. World Journal of Clinical Cases 9: 4859-4865, No. 18, 26 Jun 2021. Available from: URL: http://doi.org/10.12998/wjcc.v9.i18.4859 803592905
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