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Successful Treatment of Aggressive Large B-cell Lymphoma in Two Patients with SARS-COV2 Infection

XX Congresso Regionale FADOI CAMPANIA: Non ci siamo mai fermati
Italy 2021

Nasti R, Del Mastro A, Bresciani A, Cannavale A, Coronella C, Fortunato F, Cavallaro R, Campione S, Morella P, Laccetti M and Ferrara F

AORN A. Cardarelli, Internal Medicine Division 1, Immunology Unit, Via A. Cardarelli 9, 80131 Naples, Italy
AORN A. Cardarelli, Internal Medicine Covid Unit 4, Via A. Cardarelli 9, 80131 Naples, Italy
AORN A. Cardarelli, Internal Medicine Division 2, Via A. Cardarelli 9, 80131 Naples, Italy
AORN A. Cardarelli, Internal Medicine Division 3, Via A. Cardarelli 9, 80131 Naples, Italy
AORN A. Cardarelli, Pathology Division, Via A. Cardarelli 9, 80131 Naples, Italy
AORN A. Cardarelli, Hematology Division, Via A. Cardarelli 9, 80131 Naples, Italy

Posters & Accepted Abstracts: Health Sci J

Abstract:

Background: Diffuse large B-cell Lymphoma (DLBCL) is the most common adult Non-Hodgkin Lymphoma. Previously considered a DLBCL subtype, Primary Mediastinal B Cell Lymphoma (PMBCL) is now classified as a distinct entity. Case History: E.E., female, aged 22, was accepted to our hospital with dyspnea and dysphagia, and was isolated in the COVID Unit because of SARS-CoV-2 detection. CT scan showed a huge bulky mass compressing big vessels, heart, and trachea (Figure 1b) without pneumonia. After histological diagnosis of PMBCL with ki-67>90% (Figure 1a), MACOP-B scheme was started. After two weeks the mass was significantly reduced (Figure 1c) and chemotherapy was de-escalated, with negative SARS-CoV2 RT-PCR and subsequent discharge. A similar case of axillary aggressive DLBCL (female, 72 years) and COVID-19 pneumonia was successfully treated with COMP scheme (Figure 1de). Discussion: SARS-CoV2 pandemic has been challenging the management of haematologic patients because of the increased susceptibility for deadly SARS-CoV2 pneumonia due to immunedysregulation induced by disease and therapies; the subsequent need for strategies to vaccine and protect this population; the need for treatment strategies compatible with the infection. Our cases highlight the importance of multi-disciplinary work in the context of COVID-19 pandemic to improve the clinical outcomes of such patients. Figure 1 a: Immune-histochemical sample of Case 1: Ki-67 positivity over more than 90% of the section; bc: Case 1 CT scan at diagnosis (b) and after 3 weeks of treatment (c); de: case 2 CT scan at diagnosis (d) and after 40 days of treatment (e).