Relapsed Mantle Cell Lymphoma, Allogenic Stem Cell Transplantation and COVID-19

James Dillon; Elizabeth Higgins; Carmel-Ann Galligan; Majella Moran; Brendan Crowley; Ciaran Bannan; Carmel Waldron; Christopher Larry Bacon; Elisabeth Vandenberghe

doi:doi:10.11648/j.ajim.20210901.17

Relapsed Mantle Cell Lymphoma, Allogenic Stem Cell Transplantation and COVID-19

James Dillon, Elizabeth Higgins, Carmel-Ann Galligan, Majella Moran, Brendan Crowley, Ciaran Bannan, Carmel Waldron, Christopher Larry Bacon, Elisabeth Vandenberghe

Published in American Journal of Internal Medicine (Volume 9, Issue 1)

Received: 11 January 2021 Accepted: 25 January 2021 Published: 30 January 2021

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Abstract

The standard of care for fit patients with Mantle Cell Lymphoma (MCL) includes cytarabine containing induction treatment and consolidation with BEAM (Carmustine, Etoposide, Cytarabine and Melphalan). Chemo-refractory cases have a poorer prognosis and are candidates for allogenic stem cell transplantation (allo-SCT). Targeted therapy, such as BTK-inhibitors or BCL-mimetics can be used to bridge patients to SCT. COVID-19, a novel coronavirus has the potential to cause life threatening immune dysregulation and cytokine release syndrome (CRS) resulting in respiratory failure. Haematology patients, particularly post allogenic stem cell transplant, are high risk for developing CRS due to T-lymphopenia. PD, a 55-year-old male, with chemo-refractory MCL tested positive for COVID-19 day + 45 post allo-SCT after presenting with mild gastrointestinal symptoms and remained positive for 70 days. At day + 92 relapse was confirmed by CT and axillary node biopsy. Ibrutinib, a BTK inhibitor, was commenced with resolution of symptoms and a negative test within 20 days. With minimal reduction in adenopathy, Ibrutinib was stopped at day +110, while Cytarabine and Venetoclax (BCL-mimetic) were commenced with Donor lymphocyte infusion at day +145 resulting in complete remission. Ibrutinib’s therapeutic role against COVID-19 is now being investigated in clinical trials.

Published in	American Journal of Internal Medicine (Volume 9, Issue 1)
DOI	10.11648/j.ajim.20210901.17
Page(s)	49-51
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Mantle Cell Lymphoma, Allogenic Stem-Cell Transplantation, COVID-19, Ibrutinib, BTK-inhibitor, Venetoclax, BCL2 Mimetic, Graft Versus Host Disease

References

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[3]	Eskelund, C., Kolstad, A., Jerkeman, M., Räty, R., Laurell, A., & Eloranta, S. et al. (2016). 15-year follow-up of the Second Nordic Mantle Cell Lymphoma trial (MCL2): prolonged remissions without survival plateau. British Journal Of Haematology, 175 (3), 410-418. doi: 10.1111/bjh.14241.
[4]	Eyre, T., Walter, H., Iyengar, S., Follows, G., Cross, M., & Fox, C. et al. (2018). Efficacy of venetoclax monotherapy in patients with relapsed, refractory mantle cell lymphoma after Bruton tyrosine kinase inhibitor therapy. Haematologica, 104 (2), e68-e71. doi: 10.3324/haematol.2018.198812.
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[10]	McGee, M., August, A., & Huang, W. (2020). BTK/ITK dual inhibitors: Modulating immunopathology and lymphopenia for COVID-19 therapy. Journal Of Leukocyte Biology. doi: 10.1002/jlb.5covr0620-306r.
[11]	Ogimi, C., Greninger, A., Waghmare, A., Kuypers, J., Shean, R., & Xie, H. et al. (2017). Prolonged Shedding of Human Coronavirus in Hematopoietic Cell Transplant Recipients: Risk Factors and Viral Genome Evolution. The Journal Of Infectious Diseases, 216 (2), 203-209. doi: 10.1093/infdis/jix264.
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APA Style

James Dillon, Elizabeth Higgins, Carmel-Ann Galligan, Majella Moran, Brendan Crowley, et al. (2021). Relapsed Mantle Cell Lymphoma, Allogenic Stem Cell Transplantation and COVID-19. American Journal of Internal Medicine, 9(1), 49-51. https://doi.org/10.11648/j.ajim.20210901.17

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ACS Style

James Dillon; Elizabeth Higgins; Carmel-Ann Galligan; Majella Moran; Brendan Crowley, et al. Relapsed Mantle Cell Lymphoma, Allogenic Stem Cell Transplantation and COVID-19. Am. J. Intern. Med. 2021, 9(1), 49-51. doi: 10.11648/j.ajim.20210901.17

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AMA Style

James Dillon, Elizabeth Higgins, Carmel-Ann Galligan, Majella Moran, Brendan Crowley, et al. Relapsed Mantle Cell Lymphoma, Allogenic Stem Cell Transplantation and COVID-19. Am J Intern Med. 2021;9(1):49-51. doi: 10.11648/j.ajim.20210901.17

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@article{10.11648/j.ajim.20210901.17,
  author = {James Dillon and Elizabeth Higgins and Carmel-Ann Galligan and Majella Moran and Brendan Crowley and Ciaran Bannan and Carmel Waldron and Christopher Larry Bacon and Elisabeth Vandenberghe},
  title = {Relapsed Mantle Cell Lymphoma, Allogenic Stem Cell Transplantation and COVID-19},
  journal = {American Journal of Internal Medicine},
  volume = {9},
  number = {1},
  pages = {49-51},
  doi = {10.11648/j.ajim.20210901.17},
  url = {https://doi.org/10.11648/j.ajim.20210901.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20210901.17},
  abstract = {The standard of care for fit patients with Mantle Cell Lymphoma (MCL) includes cytarabine containing induction treatment and consolidation with BEAM (Carmustine, Etoposide, Cytarabine and Melphalan). Chemo-refractory cases have a poorer prognosis and are candidates for allogenic stem cell transplantation (allo-SCT). Targeted therapy, such as BTK-inhibitors or BCL-mimetics can be used to bridge patients to SCT. COVID-19, a novel coronavirus has the potential to cause life threatening immune dysregulation and cytokine release syndrome (CRS) resulting in respiratory failure. Haematology patients, particularly post allogenic stem cell transplant, are high risk for developing CRS due to T-lymphopenia. PD, a 55-year-old male, with chemo-refractory MCL tested positive for COVID-19 day + 45 post allo-SCT after presenting with mild gastrointestinal symptoms and remained positive for 70 days. At day + 92 relapse was confirmed by CT and axillary node biopsy. Ibrutinib, a BTK inhibitor, was commenced with resolution of symptoms and a negative test within 20 days. With minimal reduction in adenopathy, Ibrutinib was stopped at day +110, while Cytarabine and Venetoclax (BCL-mimetic) were commenced with Donor lymphocyte infusion at day +145 resulting in complete remission. Ibrutinib’s therapeutic role against COVID-19 is now being investigated in clinical trials.},
 year = {2021}
}

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TY  - JOUR
T1  - Relapsed Mantle Cell Lymphoma, Allogenic Stem Cell Transplantation and COVID-19
AU  - James Dillon
AU  - Elizabeth Higgins
AU  - Carmel-Ann Galligan
AU  - Majella Moran
AU  - Brendan Crowley
AU  - Ciaran Bannan
AU  - Carmel Waldron
AU  - Christopher Larry Bacon
AU  - Elisabeth Vandenberghe
Y1  - 2021/01/30
PY  - 2021
N1  - https://doi.org/10.11648/j.ajim.20210901.17
DO  - 10.11648/j.ajim.20210901.17
T2  - American Journal of Internal Medicine
JF  - American Journal of Internal Medicine
JO  - American Journal of Internal Medicine
SP  - 49
EP  - 51
PB  - Science Publishing Group
SN  - 2330-4324
UR  - https://doi.org/10.11648/j.ajim.20210901.17
AB  - The standard of care for fit patients with Mantle Cell Lymphoma (MCL) includes cytarabine containing induction treatment and consolidation with BEAM (Carmustine, Etoposide, Cytarabine and Melphalan). Chemo-refractory cases have a poorer prognosis and are candidates for allogenic stem cell transplantation (allo-SCT). Targeted therapy, such as BTK-inhibitors or BCL-mimetics can be used to bridge patients to SCT. COVID-19, a novel coronavirus has the potential to cause life threatening immune dysregulation and cytokine release syndrome (CRS) resulting in respiratory failure. Haematology patients, particularly post allogenic stem cell transplant, are high risk for developing CRS due to T-lymphopenia. PD, a 55-year-old male, with chemo-refractory MCL tested positive for COVID-19 day + 45 post allo-SCT after presenting with mild gastrointestinal symptoms and remained positive for 70 days. At day + 92 relapse was confirmed by CT and axillary node biopsy. Ibrutinib, a BTK inhibitor, was commenced with resolution of symptoms and a negative test within 20 days. With minimal reduction in adenopathy, Ibrutinib was stopped at day +110, while Cytarabine and Venetoclax (BCL-mimetic) were commenced with Donor lymphocyte infusion at day +145 resulting in complete remission. Ibrutinib’s therapeutic role against COVID-19 is now being investigated in clinical trials.
VL  - 9
IS  - 1
ER  -

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Author Information

James Dillon

Department of Haematology, St James’s Hospital, Dublin, Ireland
Elizabeth Higgins

Department of Haematology, St James’s Hospital, Dublin, Ireland
Carmel-Ann Galligan

Department of Haematology, St James’s Hospital, Dublin, Ireland
Majella Moran

Department of Haematology, St James’s Hospital, Dublin, Ireland
Brendan Crowley

Department of Virology, St James’s Hospital, Dublin, Ireland
Ciaran Bannan

Department of Infectious Diseases, St James’s Hospital, Dublin, Ireland
Carmel Waldron

Department of Haematology, St James’s Hospital, Dublin, Ireland
Christopher Larry Bacon

Department of Haematology, St James’s Hospital, Dublin, Ireland
Elisabeth Vandenberghe

Department of Haematology, St James’s Hospital, Dublin, Ireland

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APA Style

James Dillon, Elizabeth Higgins, Carmel-Ann Galligan, Majella Moran, Brendan Crowley, et al. (2021). Relapsed Mantle Cell Lymphoma, Allogenic Stem Cell Transplantation and COVID-19. American Journal of Internal Medicine, 9(1), 49-51. https://doi.org/10.11648/j.ajim.20210901.17

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ACS Style

James Dillon; Elizabeth Higgins; Carmel-Ann Galligan; Majella Moran; Brendan Crowley, et al. Relapsed Mantle Cell Lymphoma, Allogenic Stem Cell Transplantation and COVID-19. Am. J. Intern. Med. 2021, 9(1), 49-51. doi: 10.11648/j.ajim.20210901.17

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AMA Style

James Dillon, Elizabeth Higgins, Carmel-Ann Galligan, Majella Moran, Brendan Crowley, et al. Relapsed Mantle Cell Lymphoma, Allogenic Stem Cell Transplantation and COVID-19. Am J Intern Med. 2021;9(1):49-51. doi: 10.11648/j.ajim.20210901.17

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@article{10.11648/j.ajim.20210901.17,
  author = {James Dillon and Elizabeth Higgins and Carmel-Ann Galligan and Majella Moran and Brendan Crowley and Ciaran Bannan and Carmel Waldron and Christopher Larry Bacon and Elisabeth Vandenberghe},
  title = {Relapsed Mantle Cell Lymphoma, Allogenic Stem Cell Transplantation and COVID-19},
  journal = {American Journal of Internal Medicine},
  volume = {9},
  number = {1},
  pages = {49-51},
  doi = {10.11648/j.ajim.20210901.17},
  url = {https://doi.org/10.11648/j.ajim.20210901.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20210901.17},
  abstract = {The standard of care for fit patients with Mantle Cell Lymphoma (MCL) includes cytarabine containing induction treatment and consolidation with BEAM (Carmustine, Etoposide, Cytarabine and Melphalan). Chemo-refractory cases have a poorer prognosis and are candidates for allogenic stem cell transplantation (allo-SCT). Targeted therapy, such as BTK-inhibitors or BCL-mimetics can be used to bridge patients to SCT. COVID-19, a novel coronavirus has the potential to cause life threatening immune dysregulation and cytokine release syndrome (CRS) resulting in respiratory failure. Haematology patients, particularly post allogenic stem cell transplant, are high risk for developing CRS due to T-lymphopenia. PD, a 55-year-old male, with chemo-refractory MCL tested positive for COVID-19 day + 45 post allo-SCT after presenting with mild gastrointestinal symptoms and remained positive for 70 days. At day + 92 relapse was confirmed by CT and axillary node biopsy. Ibrutinib, a BTK inhibitor, was commenced with resolution of symptoms and a negative test within 20 days. With minimal reduction in adenopathy, Ibrutinib was stopped at day +110, while Cytarabine and Venetoclax (BCL-mimetic) were commenced with Donor lymphocyte infusion at day +145 resulting in complete remission. Ibrutinib’s therapeutic role against COVID-19 is now being investigated in clinical trials.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - Relapsed Mantle Cell Lymphoma, Allogenic Stem Cell Transplantation and COVID-19
AU  - James Dillon
AU  - Elizabeth Higgins
AU  - Carmel-Ann Galligan
AU  - Majella Moran
AU  - Brendan Crowley
AU  - Ciaran Bannan
AU  - Carmel Waldron
AU  - Christopher Larry Bacon
AU  - Elisabeth Vandenberghe
Y1  - 2021/01/30
PY  - 2021
N1  - https://doi.org/10.11648/j.ajim.20210901.17
DO  - 10.11648/j.ajim.20210901.17
T2  - American Journal of Internal Medicine
JF  - American Journal of Internal Medicine
JO  - American Journal of Internal Medicine
SP  - 49
EP  - 51
PB  - Science Publishing Group
SN  - 2330-4324
UR  - https://doi.org/10.11648/j.ajim.20210901.17
AB  - The standard of care for fit patients with Mantle Cell Lymphoma (MCL) includes cytarabine containing induction treatment and consolidation with BEAM (Carmustine, Etoposide, Cytarabine and Melphalan). Chemo-refractory cases have a poorer prognosis and are candidates for allogenic stem cell transplantation (allo-SCT). Targeted therapy, such as BTK-inhibitors or BCL-mimetics can be used to bridge patients to SCT. COVID-19, a novel coronavirus has the potential to cause life threatening immune dysregulation and cytokine release syndrome (CRS) resulting in respiratory failure. Haematology patients, particularly post allogenic stem cell transplant, are high risk for developing CRS due to T-lymphopenia. PD, a 55-year-old male, with chemo-refractory MCL tested positive for COVID-19 day + 45 post allo-SCT after presenting with mild gastrointestinal symptoms and remained positive for 70 days. At day + 92 relapse was confirmed by CT and axillary node biopsy. Ibrutinib, a BTK inhibitor, was commenced with resolution of symptoms and a negative test within 20 days. With minimal reduction in adenopathy, Ibrutinib was stopped at day +110, while Cytarabine and Venetoclax (BCL-mimetic) were commenced with Donor lymphocyte infusion at day +145 resulting in complete remission. Ibrutinib’s therapeutic role against COVID-19 is now being investigated in clinical trials.
VL  - 9
IS  - 1
ER  -

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