A Fatal Breakthrough COVID-19 Case Following Bendamustine-Rituximab Therapy

Kohei Kamegai; Noriko Iwamoto; Tomiteru Togano; Kenji Maeda; Yuki Takamatsu; Yusuke Miyazato; Masahiro Ishikane; Masashi Mizokami; Masaya Sugiyama; Shun Iida; Sho Miyamoto; Tadaki Suzuki; Norio Ohmagari

doi:10.1016/j.ijid.2022.04.058

A Fatal Breakthrough COVID-19 Case Following Bendamustine-Rituximab Therapy

Int J Infect Dis. 2022 Aug:121:85-88. doi: 10.1016/j.ijid.2022.04.058. Epub 2022 Apr 30.

Authors

Affiliations

¹ National Center for Global Health and Medicine, Tokyo, Japan.
² National Center for Global Health and Medicine, Tokyo, Japan. Electronic address: nkinoshita@hosp.ncgm.go.jp.
³ Department of Refractory Viral Infections, National Center for Global Health and Medicine Research Institute.
⁴ Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan.

Abstract

Although messenger ribonucleic acid vaccines are substantially effective toward SARS-CoV-2 infection, patients with hematologic malignancies are still prone to the virus. Herein, we report a fatal case of breakthrough SARS-CoV-2 Delta variant infection in a patient with mucosa-associated lymphoid tissue lymphoma with remission by bendamustine-rituximab (BR) therapy completed a year ago. The serologic study revealed impaired responsiveness toward vaccines and prolonged high viral load after infection. BR therapy seemingly induced an immune escape. Prevention and treatment strategies for such vulnerable patients should be clarified immediately.

Keywords: Bendamustine-rituximab therapy; Breakthrough; COVID-19; Fatal; Immune escape.

Publication types

Case Reports

MeSH terms

Antineoplastic Combined Chemotherapy Protocols / adverse effects
Bendamustine Hydrochloride / adverse effects
COVID-19 Drug Treatment*
Humans
Rituximab / adverse effects
SARS-CoV-2*

Substances

Rituximab
Bendamustine Hydrochloride

Supplementary concepts

SARS-CoV-2 variants