Tohoku J. Exp. Med., 2022 September, 258(1)

COVID-19 in a Hairy Cell Leukemia Patient: A Rare Case Report

Hirohito Sano,¹ Koji Murakami,¹ Hisayuki Yokoyama,² Chie Suzuki,³ Yudai Iwasaki,⁴ Eiichi Kodama⁵ and Hisatoshi Sugiura¹

¹Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
²Department of Hematology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
³Laboratory Diagnostics, Tohoku University Hospital, Sendai, Miyagi, Japan
⁴Department of Anesthesiology and Perioperative Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
⁵Department of Infectious Diseases, International Research Institute of Disaster Science, Graduate School of Medicine, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan

The detailed clinical course of coronavirus disease 2019 (COVID-19) in patients with hairy cell leukemia (HCL) is rarely reported. We report the first case of HCL diagnosed with prolonged pancytopenia after COVID-19 infection in Japan. We describe the case of a 56-year-old man who was diagnosed with COVID-19. Computed tomography revealed ground-glass opacities in the bilateral lung lobes as well as splenomegaly. Remdesivir and dexamethasone were administered for the treatment of COVID-19. Since the pancytopenia persisted, bone marrow examination was performed, and he was diagnosed with HCL. Although pancytopenia can occur with COVID-19 alone, clinicians should be alerted regarding the presence of hematologic malignancies in patients in whom pancytopenia persists after COVID-19 treatment or in those with splenomegaly. Further, the condition of all previously reported patients with COVID-19 associated with HCL was severe enough to require mechanical ventilation. This is the first case in which the disease was not severe. The interleukin-6 (IL-6) level was lower in this case than in previous cases, suggesting that racial differences in IL-6 production may have contributed to COVID-19 severity.

Keywords —— coronavirus disease 2019; hairy cell leukemia; interleukin-6; pancytopenia; splenomegaly

© 2022 Tohoku University Medical Press

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Tohoku J. Exp. Med 2022, 258, 63-68.

Correspondence: Hirohito Sano, M.D., Ph.D., Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.

e-mail: sendai_dc_1231@rm.med.tohoku.co.jp