2025 Volume 62 Issue 1 Pages 90-93
A 4-year-old girl with T-cell acute lymphoblastic leukemia achieved first remission after induction therapy and negative minimal residual disease after early intensification chemotherapy. However, she was identified as carrying a TCF7::SPI1 fusion, predicting a poor prognosis. She underwent unrelated cord blood transplantation with reduced-intensity conditioning during the first complete remission. On day 3 after transplantation, the patient developed a fever and was diagnosed with COVID-19. Chest computed tomography revealed left lower lung pneumonia. The patient was treated with remdesivir for 10 days and recovered without disease progression. Despite engraftment on day 23 after transplantation, the polymerase chain reaction for severe acute respiratory syndrome coronavirus 2 remained positive for 89 days. Although early onset COVID-19 after hematopoietic cell transplantation is associated with a high severity risk, early therapeutic intervention prevented disease progression in this case, in which delayed viral clearance was observed during post-transplant immunosuppression. This was consistent with previous reports.
