Successful treatment of chronic myelomonocytic leukaemia with hydroxycarbamide in a patient presenting with acute hypoxic respiratory failure due to COVID‐19 pneumonia

Abstract

On 30th March 2020, a 57‐year‐old male patient presented to the Emergency Department with a 6‐day history of cough, persistent fevers and worsening dyspnoea. His only known comorbidity was hypertension, managed with amlodipine and an angiotensin converting enzyme inhibitor. On admission, he was tachypnoeic and in severe hypoxic respiratory failure with dangerously low peripheral oxygen saturations (SpO 2 ) 83% on 15L oxygen. Chest radiographic changes were consistent with COVID‐19 infection and demonstrated bilateral changes with diffuse airspace shadowing with more confluence in the lower zones (Figure 1A).

The management of hematologic malignancies during the COVID-19 pandemic

“…Monocytes in CMML patients exhibit a proinflammatory transcriptional signature [94] and in the course of infection, a severe leukemoid reaction can occur [95,96]; therefore, it is believed that patients with CMML should be exposed to potential contact with COVID-19 as little as possible. If the clinical situation allows, a 'watch and wait' strategy for patients should be implemented.…”

COVID-19 in a patient with chronic myelomonocytic leukemia: a twisting tale

“…5 During COVID-19 pandemic, 'wait and watch' could be considered for CMML patients with asymptomatic disease. Hydroxyurea could be considered for patients with proliferative CMML in whom treatment is indicated [18]. 6 In addition to standard infection screen, testing for COVID-19 may be considered in patients with FN, or diarrhea [10][11][12]19].…”

“…In addition to the novel finding of acquired factor X inhibitor in a very young patient with proliferative CMML, the current case illustrates several aspects that are potentially relevant during the COVID-19 pandemic. Only a few cases of CMML with COVID-19 have been reported to date [4,18]. Highlights of the relevant evidence-based discussion points from this case are summarized in Table 1 [4, 8-12, 16, 18, 19].…”