A Fatal Breakthrough COVID-19 Case Following Bendamustine-Rituximab Therapy

https://doi.org/10.1016/j.ijid.2022.04.058Get rights and content
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Highlights

  • We report a fatal case of breakthrough infection with the SARS-CoV-2 Delta variant after the first vaccination course.

  • Patients with hematologic malignancies are vulnerable to COVID-19 viral infection.

  • Surveillance of mixed alleles could help detect unknown aggravating factors.

Abstract

Although messenger ribonucleic acid vaccines are substantially effective toward SARS-CoV-2 infection, patients with hematologic malignancies are still prone to the virus. Herein, we report a fatal case of breakthrough SARS-CoV-2 Delta variant infection in a patient with mucosa-associated lymphoid tissue lymphoma with remission by bendamustine-rituximab (BR) therapy completed a year ago. The serologic study revealed impaired responsiveness toward vaccines and prolonged high viral load after infection. BR therapy seemingly induced an immune escape. Prevention and treatment strategies for such vulnerable patients should be clarified immediately.

Keywords

COVID-19
Breakthrough
Fatal
Bendamustine-rituximab therapy
Immune escape

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