Management of Persistent SARS-CoV-2 Infection in Patients with Follicular Lymphoma.

INTRODUCTION: There is no consensus on the management of the coronavirus disease (COVID-19) in patients with secondary immunosuppression due to either an underlying hematological disease or to the effects of immunochemotherapy (ICT). Some of them may present persistent infection with multiple relapses of COVID-19, requiring several admissions. This study evaluated the clinical characteristics and outcomes after treatment of 5 patients with follicular lymphoma (FL), previously treated with ICT, who developed several episodes of COVID-19. METHODS: We analyzed the clinical evolution and response to treatment with antiviral agent, steroids, and convalescent plasma in 5 patients with FL and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) persistent infection. Reverse transcriptase polymerase chain reaction tests and peripheral blood immunophenotype were performed for all patients. RESULTS: All patients required hospitalization due to pneumonia with severity criteria and were re-admitted after a median of 22 days (13-42) from the previous discharge. They all showed B-cell depletion by immunophenotyping, and no traces of immunoglobulin antibodies against SARS-CoV-2 were detected in any of the cases. The survival rate was 80%. CONCLUSION: The combination therapy evidenced clinical benefits, demonstrating its capacity to control infection in immunosuppressed FL patients treated with ICT.

Shewanella alga bacteremia and associated cellulitis in a patient with multiple myeloma.

Shewanella alga is a gram-negative bacillus found in all types of water as well as in a variety of tainted food. It has rarely been associated with human disease, either in healthy or in immunocompromised patients. We report a 66-year-old man with a multiple myeloma who developed a cellulitis in both forearms in the course of a Shewanella bacteremia. He had a renal insufficiency and was moderately neutropenic after chemotherapy (vincristine, adriamycin, dexamethasone). Outcome was good after treatment with ceftazidime-amikacin despite all the risk factors. Shewanella isolation may be clinically significant. Haematological patients constitute a group of risk as increasingly aggressive chemotherapy regimens are used. Clinical outcome is not necessarily bad.