2 research outputs found
Development of leukemia after COVID-19 infection
Abstract. Many aspects of the COVID-19 infection, especially its complications and longterm health consequences, are still unknown. Various reactive changes in the blood test during the
course of leukemia have been published. Leukocytosis [1], leukopenia [2, 3, 4], neutrophilia [5, 6],
lymphocytosis and lymphocytopia [3, 7], thrombocytopenia and, rarely, thrombocytosis [2, 8, 9]
were found most often.
The detected changes were usually not subject to monitoring in the patient. There are reports
of the diagnosis of leukemia after a recent infection with COVID-19. Therefore, studying the
features of the clinical picture and hematopoiesis in such patients during the course of a viral
infection, as well as in the initial manifestations of leukemia, is relevant
The Development of Leukemia after a Sustained COVID-19 Infection
The purpose of the study was to review the literature on cases of leukemia in healthy people after the COVID-19 infection
with a description of our own observation. Materials and methods. 26 literature sources were reviewed and analyzed
using the PubMed/MEDLINE database regarding diagnosis of the leukemic process in patients after COVID-19. Analytical
and bibliosemantic methods were used in the research. Results and discussion. Many aspects of the COVID-19 infection,
especially its complications and long-term health consequences, are still unknown. Various reactive changes in blood
tests during COVID-19 have been published. Leukocytosis, leukopenia, neutrophilia, lymphocytosis and
lymphocytopenia, thrombocytopenia and rarely thrombocytosis were most often detected. The detected changes were
usually not observable in patients. There are reports of leukemia after a recent COVID-19. Therefore, studying the
features of the clinical picture and hematopoiesis in such patients during a viral infection, as well as at the initial
manifestations of leukemia, is relevant. Costa B. and co-authors report cases of the development of the leukemic process
in previously healthy young patients. Patients are aged 31-35 years with normal blood tests, in whom the manifestation of
leukemia appeared approximately 2-3 months after COVID-19. The course of COVID-19 was not severe in all. Mild
microcytaria was detected in one case of hypochromic anemia. The development of malignant hematological diseases in
these patients with an unfavorable prognosis for the course and response to treatment attracts attention. These was T-cell acute lymphoblastic leukemia, myelodysplastic syndrome, acute myeloid leukemia with trigeminal dysplasia in the
bone marrow, suggesting previous myelodysplastic syndrome. Nekooghadam S. M. and co-authors presented a case of
acute myeloid leukemia in a man after recovery from COVID-19 after 1.5 months. The course of the infection was severe.
The blood test showed slight leukocytosis. Manifestations of the described cases of leukemia included clinical
gastroenteropathy and anemic syndrome. Two- or three-fold severe pancytopenia and dysplasia were more common in
the analysis of bone marrow hematopoiesis. Low blastemia was a feature. Some authors suggest that SARS-Cov-2 plays
a role in leukogenesis. The leading role in this is attributed to the imbalance of the renin-angiotensin system caused by
the virus, which triggers leukogenesis in several mechanisms. An abnormal immune response to a viral infection can
trigger secondary mutational events, contributing to the clinical development of leukemia. In addition to the effect of
SARS-CoV-2 on renin-angiotensin system, other mechanisms of the potential development of cancer may underlie it. In
particular, COVID-19 has been associated with T-cell exhaustion and activation of oncogenic pathways, including JAK-STAT, MAPK, and NF-kB. The coronavirus non-structural protein stabilizes factors by increasing RCHY1-mediated
apoptosis-associated degradation of p53. The case of an acute leukemic process described by us was distinguished by a
rapid atypical course, neurological symptoms, pancytopenia in peripheral blood during hospitalization, and a changed
linear morphology of blast cells. Conclusion. According to the literature, the leukemic process after a sustained COVID-19
more often has an acute myeloid variant with hematopoietic dysplasia and a severe atypical course. Hematological
monitoring of patients who have undergone COVID-19 in the presence of an oncology history or changes in the blood
test during recovery from it is necessary. It is advisable to have a control of the hemogram after 2-3 months