Major rise of a chronic lymphoid leukemia clone during the course of COVID‐19

• Published in: International Journal of Laboratory Hematology 2021-04, Vol.43 (2), p.e82-e83
• Main Authors: Largeaud, Laetitia, Ribes, Agnès, Dubois‐Galopin, Frédérique, Mémier, Vincent, Rolland, Yves, Gaudin, Clément, Rousset, David, Geeraerts, Thomas, Noel‐Savina, Elise, Rieu, Jean‐Baptiste, Vergez, François
• Format: Article
• Language: English
• Subjects: Aged, 80 and over; Aged80 and over; Chronic lymphocytic leukemia; Clone Cells; Complementarity Determining Regions - genetics; Complementarity Determining Regions - immunology; COVID-19; COVID-19 - diagnostic imaging; COVID-19 - immunology; COVID-19 - pathology; COVID-19 - virology; Disease Progression; Gene Expression; Humans; Leukemia, Lymphocytic, Chronic, B-Cell - diagnostic imaging; Leukemia, Lymphocytic, Chronic, B-Cell - immunology; Leukemia, Lymphocytic, Chronic, B-Cell - pathology; Leukemia, Lymphocytic, Chronic, B-Cell - virology; Life Sciences; Lymphatic leukemia; Lymphocytes - immunology; Lymphocytes - pathology; Lymphocytes - virology; Lymphocytosis - diagnostic imaging; Lymphocytosis - immunology; Lymphocytosis - pathology; Lymphocytosis - virology; Male; Mutation; Remission, Spontaneous; SARS-CoV-2 - immunology; SARS-CoV-2 - pathogenicity; Severity of Illness Index; Tomography, X-Ray Computed; Tumor Suppressor Protein p53 - genetics; Tumor Suppressor Protein p53 - immunology
• ISSN: 1751-5521; 1751-553X; 1365-2257
• DOI: 10.1111/ijlh.13383

Initially, the most relevant clinical findings were body temperature of 39.1°C, white blood cell counts 3.16 × 109/L, lymphocytes 1.2 × 109/L, hemoglobin 120 g/L, platelet count 92 × 109/L, D‐Dimer 1290 ng/mL, and C‐reactive protein (CRP) 34 mg/L (Table S1). Mutational status showed somatic hypermutation on the two IGHV4‐34 genes. [...]a TP53 mutation was found with 35% of variant allele frequency. [...]the altered functions of immune elements during virus infection could be decisive for CLL onset.3 Studies have reported the possible association between CLL risk and increased levels of immune markers as IL4,4 IL10, or TNF‐α.5, 6 Cytokine dysregulation is particularly important in patients with COVID‐19, who have high levels of IL‐1ra, IL‐6, IL‐7, IL‐8, IL‐10, G‐CSF, GM‐CSF, IFNg, MCP‐1, and TNF‐α.2, 7 In the described case of COVID‐19 patient, the quick rise of circulating clonal lymphocytes during hospitalization is unusual and raise the question of indirect role of SARS‐CoV‐2, due to cytokine stimulation.