Plitidepsin as a successful rescue treatment for prolonged viral SARS-CoV-2 replication in a patient with previous anti-CD20 monoclonal antibody-mediated B cell depletion and chronic lymphocytic leukemia.

Abstract

BACKGROUND:

There is an urgent need for highly efficacious antiviral therapies in immunosuppressed hosts who develop coronavirus disease (COVID-19), with special concern for those affected by hematological malignancies.

CASE PRESENTATION:

Here, we report the case of a 75-year-old male with chronic lymphocytic leukemia who was deficient in CD19+CD20+ B-lymphocyte populations due to previous treatment with anti-CD20 monoclonal antibodies. The patient presented with severe COVID-19 pneumonia due to prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and was treated with two courses of the antiviral plitidepsin on a compassionate use basis. The patient subsequently achieved an undetectable viral load, and his pneumonia resolved.

CONCLUSIONS:

Treatment with plitidepsin was well-tolerated without any further hematological or cardiovascular toxicities. This case further supports plitidepsin as a potential antiviral drug in SARS-CoV-2 patients affected by immune deficiencies and hematological malignancies.

• Authors: P Guisado-Vasco, M M Carralón-González, J Aguareles-Gorines, E M Martí-Ballesteros, M D Sánchez-Manzano, D Carnevali-Ruiz, M García-Coca, R Barrena-Puertas, R García de Viedma, J M Luque-Pinilla, G Sotres-Fernandez, J M Fernández-Sousa, X E Luepke-Estefan, J A López-Martín, J M Jimeno
• Journal: Journal of hematology & oncology (J Hematol Oncol) Vol. 15 Issue 1 Pg. 4 (01 10 2022) ISSN: 1756-8722 [Electronic] England
• PMID: 35012608 (Publication Type: Case Reports, Letter, Research Support, Non-U.S. Gov't)
• Copyright: © 2021. The Author(s).

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Antigens, CD20
• Depsipeptides
• Peptides, Cyclic
• obinutuzumab
• plitidepsin

Topics

• Aged
• Antibodies, Monoclonal (therapeutic use)
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Antigens, CD20 (immunology)
• B-Lymphocytes (drug effects, metabolism)
• COVID-19 (complications, prevention & control, virology)
• Depsipeptides (therapeutic use)
• Humans
• Leukemia, Lymphocytic, Chronic, B-Cell (complications, drug therapy)
• Lymphocyte Depletion (methods)
• Male
• Peptides, Cyclic (therapeutic use)
• SARS-CoV-2 (drug effects, genetics, physiology)
• Treatment Outcome
• Virus Replication (drug effects)