The use of tyrosine kinase inhibitor (TKI) therapy may provide a degree of protection against COVID-19 in patients with chronic myeloid leukemia (CML). These findings are suggested by in a case report and literature review published in the European Journal of Case Reports in Internal Medicine.
The case report involved a 42-year-old man treated for chronic phase CML with dasatinib who had achieved major molecular response in October 2020. In December 2020, he developed COVID-19, for which he was seen at an emergency department. His white blood cell count was 4.4×103/mm3, hemoglobin level was 11.5 g/dL, and his platelet count was 106 K/mm3. After achieving hemodynamic and clinical stability, he was discharged and instructed to continue taking dasatinib.
At a follow-up 2 weeks later, the patient showed resolution of respiratory symptoms and his blood counts had improved. His white blood cell count had increased to 6.9×103/mm3, his hemoglobin level was 13.4 g/dL, and his platelet count was 124 K/mm3.
In a review of literature on patients with COVID-19 treated with TKI therapy for CML, the researchers identified 8 reports. One retrospective study compared patients receiving a TKI for CML and control subjects without cancer. In this study, rates of intensive care or mechanical ventilation for patients with CML receiving a TKI trended lower, in a nonsignificant fashion, than in matched controls. Hospital stays similarly showed a trend of being shorter among the patients with CML, and the case fatality rate was lower in the patients with CML.
“While the data are promising, larger prospective and perhaps randomized studies are necessary to examine the outcome of COVID-19 in patients with CML and to clarify the role of TKI therapy and its possible antiviral effect during the pandemic,” the researchers concluded in their report.
Reference
Singh B, Ayad S, Kaur P, Kumar V, Gupta S, Maroules M. COVID-19-induced pancytopenia in a major molecular response CML patient on dasatinib: a case report and review of the literature. Eur J Case Rep Intern Med. 2021;8(1):002233. doi:10.12890/2021_002233