SARS-CoV-2 convalescent plasma therapy in pediatric patient after hematopoietic stem cell transplantation.
COVID-19
Convalescent plasma
Immunocompromised patients
Pediatric
Stem cell transplantation
Journal
Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis
ISSN: 1473-0502
Titre abrégé: Transfus Apher Sci
Pays: England
ID NLM: 101095653
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
14
10
2020
accepted:
27
10
2020
pubmed:
7
11
2020
medline:
30
3
2021
entrez:
6
11
2020
Statut:
ppublish
Résumé
Immunocompromised patients, including HSCT recipients, may have a poor prognosis after contracting COVID-19 due to the absence of a pathogen-specific adaptive immune response. One of the possible options for severe COVID-19 treatment may be the transfusion of hyperimmune SARS-CoV-2 convalescent plasma. A 9-month-old girl with juvenile myelomonocytic leukemia received an HSCT from a haploidentical donor. On day +99, during routine virologic monitoring, SARS-CoV-2 was detected without any clinical symptoms. On day +144, the child developed a polysegmental bilateral viral pneumonia with 60 % damage to the lung tissue and confirm a positive SARS-Cov-2 results in throat swab. The patient was treated with tocilizumab and three doses of fresh frozen plasma obtained from a SARS-CoV-2 convalescent patient. Therapy with tocilizumab and three doses of fresh frozen plasma was well tolerated. In spite of full resolution of the lung lesions, complete elimination of SARS-CoV-2 has not been achieved 4 months after the first detection, which is due to persistence of secondary immunodeficiency after HSCT and the lack of reconstitution of the adaptive immune response. This case represents a demonstration of an atypical course of COVID-19 and the delayed development of lung lesions, which was most likely associated with the features of the patient's immune status after HSCT. SARS-CoV-2 convalescent plasma in combination with other therapeutic approaches is one of the possible curative options for this clinical situation.
Identifiants
pubmed: 33153902
pii: S1473-0502(20)30305-0
doi: 10.1016/j.transci.2020.102983
pmc: PMC7604030
pii:
doi:
Substances chimiques
Antibodies, Monoclonal, Humanized
0
tocilizumab
I031V2H011
Types de publication
Case Reports
Journal Article
Langues
eng
Pagination
102983Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.
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