Diagnosing B-cell acute lymphoblastic leukemia in 2 pediatric patients with recent SARS-CoV-2 infection.

Autor: Mitra A; Department of Pathology and Laboratory Medicine, University of California Davis Medical Center, Sacramento, CA, USA., Ladenheim A; Department of Pathology and Laboratory Medicine, University of California Davis Medical Center, Sacramento, CA, USA., Datta-Mitra A; Department of Pathology and Laboratory Medicine, University of California Davis Medical Center, Sacramento, CA, USA., Honeychurch KL; Department of Pediatrics, University of California Davis Medical Center, Sacramento, CA, USA., Dwyre DM; Department of Pathology and Laboratory Medicine, University of California Davis Medical Center, Sacramento, CA, USA., Graff JP; Department of Pathology and Laboratory Medicine, University of California Davis Medical Center, Sacramento, CA, USA.
Jazyk: angličtina
Zdroj: Clinical pathology (Thousand Oaks, Ventura County, Calif.) [Clin Pathol] 2024 Sep 06; Vol. 17, pp. 2632010X241278180. Date of Electronic Publication: 2024 Sep 06 (Print Publication: 2024).
DOI: 10.1177/2632010X241278180
Abstrakt: COVID-19 infection is still a mystery in terms of its long-term effect on health and its consequences on hematological disorders. Prior studies including ours have shown the abnormal changes in hematopoietic cells in COVID-19 patients. In this article, we are presenting 2 cases of pediatric B-lymphoblastic leukemia (B-ALL) with a previous history of COVID-19 infection. The first case describes a 22-month-old boy presenting with lymphadenopathy, neutropenia, and anemia with concurrent COVID-19 infection without any evidence of a hematolymphoid neoplasm as per bone marrow and lymph node biopsy. However, he presented after 2 months with bone marrow biopsy confirming B-ALL. The second case is that of a 4-year-old girl presenting with B-ALL who has had asymptomatic COVID-19 infection 5 months before this current presentation. Both the cases had complete resolution of COVID-19 infection during the time of presentation with acute leukemia. There were notably 2 rare findings along the course of the patients' illnesses. First, the unusual plasmacytosis in the marrow during active COVID-19 infection in the first patient and the second, is predilection of development of B-ALL following COVID-19. In both the cases the fluorescence in situ hybridization (FISH) studies showed pathologic alteration of the RUNX1 gene. Overall, there are no literature to support a causal association between acute B-ALL and COVID-19. The diagnosis of B-ALL in these patients after COVID-19 infection may be totally unrelated. However, if we consider Greaves proposed 2-hit model for childhood acute leukemia, that an infectious agent can precipitate development of B-ALL in a genetically susceptible individual. Alteration of the RUNX1 gene in both the patients, opens a door for further exploration of the "second-hit" hypothesis regarding an infectious agent precipitating development of B-ALL in a genetically susceptible individual.
Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
(© The Author(s) 2024.)
Databáze: MEDLINE
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