CASE PRESENTATION OF 55-YEAR-OLD MAN WITH ACUTE MYELOID LEUKEMIA AND COVID 19

N. Sari, H. A. Wulanjani, Ardhea Jaludamascena, D. Retnoningrum
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Abstract

Background: Acute myeloid leukemia (AML) is a malignancy originating from multipotential hematopoietic cells, which is characterized by clonal proliferation of abnormal blast cells in the bone marrow and failure of normal cell production. Coronavirus disease-19 (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. COVID-19 infection in AML patients will affect laboratory examinations to support the diagnosis of COVID-19 and the patient's prognosis. Case presentation: A 55-year- old man went to the hospital for chemotherapy and diagnosed of acute myelomonocytic leukemia. Patient complains of his gingival bleeding. The results of the routine haematological examination showed pancytopenia and the patient requires blood transfusion before chemotherapy. On the third day of treatment, the patient complained of fever, after several day patient complained cough, and shortness of breath. Physical examination showed pulse 100x/minutes, respiratory rate 26x/minutes, temperature 39.8˚C, crackles of the lungs. RT-PCR examination from nasopharyngeal swab showed a positive SARS-CoV-2. During treatment, the laboratory tests showed pancytopenia, increased D-Dimer, C-reactive protein, ferritin and procalcitonin. After the 42th day of treatment, the patient had clinical improvement, the fifth evaluation swab showed a negative RT-PCR result. Conclusion: AML patients have a higher risk of infection, especially COVID-19 infection. Correct laboratory examinations and treatment will promote a better prognosis. It is necessary to educate leukemic patients so that they always take precautions against infection, especially the prevention of COVID-19. 
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55岁男性急性髓性白血病合并covid - 19病例报告
背景:急性髓性白血病(Acute myeloid leukemia, AML)是一种起源于多潜能造血细胞的恶性肿瘤,其特点是骨髓中异常母细胞的克隆性增殖和正常细胞产生的失败。冠状病毒病-19 (COVID-19)是由SARS-CoV-2病毒引起的传染病。AML患者感染COVID-19将影响实验室检查以支持COVID-19的诊断和患者的预后。病例介绍:一名55岁男子到医院接受化疗,诊断为急性髓细胞白血病。病人抱怨他的牙龈出血。常规血液学检查显示全血细胞减少,化疗前需输血。在治疗的第三天,患者主诉发热,几天后患者主诉咳嗽,呼吸急促。体格检查脉搏100次/分钟,呼吸频率26次/分钟,体温39.8℃,肺有杂音。鼻咽拭子RT-PCR检测显示SARS-CoV-2阳性。在治疗期间,实验室检查显示全血细胞减少,d -二聚体、c反应蛋白、铁蛋白和降钙素原增加。治疗第42天,患者临床好转,第5次评估拭子RT-PCR结果为阴性。结论:AML患者感染风险较高,尤其是COVID-19感染风险较高。正确的实验室检查和治疗将促进更好的预后。有必要对白血病患者进行教育,使其时刻做好预防感染的措施,特别是预防COVID-19。
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