Allogeneic Hematopoietic Stem Cell Transplant for Acute Lymphoblastic Leukemia in a Pediatric Patient After COVID-19 Infection Complicated by MIS-C.
Kayleigh M Schwartz, Chelsea Honstain, Jessica L Spruit and 1 others
PMID 35256228WHAT IT FOUND
After MIS-C and SARS-CoV-2, a child with leukemia received unrelated donor HSCT 12 weeks later.
At day 30, he had stage 1 skin GVHD but normal ventricular function on echocardiogram.
Key findings
01A 3-year-old male with B-ALL developed febrile neutropenia during reinduction and later had a positive nasopharyngeal SARS-CoV-2 PCR.
02He met CDC criteria for MIS-C and had markedly elevated IL-2R, IL-6, IL-8, and IL-13.
03He was admitted for matched unrelated allogeneic HSCT 12 weeks after treatment, and a day 30 post-HSCT evaluation showed stage 1 skin GVHD.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This is a single case report, so it describes what happened to one child and cannot show that HSCT after MIS-C is safe or effective. The child received many treatments at the same time, including chemotherapy, antibiotics, transfusions, remdesivir, anakinra, intravenous immunoglobulin, corticosteroids, and aspirin, so the effect of any one treatment cannot be separated. Follow-up was only 80 days post-HSCT, and long-term outcomes were pending. The report has no comparison group, randomisation, or blinded outcome assessment. The authors state no sinusoidal obstruction syndrome, transplant-associated thrombotic microangiopathy, or high-grade GVHD, but the child did have stage 1 skin GVHD, C. difficile, oral candida, and needed total parenteral nutrition.
The easy way to misread this
Do not read this as evidence that HSCT after MIS-C is safe or effective. It is one child's course, he had complications including C. difficile and skin GVHD, and the report gives no comparison group or long-term follow-up.