Share

September 18, 2020 A coronavirus positive girl underwent an allogeneic hematopoietic stem cell transplant at the Meyer pediatric hospital in Florence to treat a very high-risk form of myeloid leukemia. It was a difficult choice that the doctors faced a few weeks ago, also because the case is unprecedented in Italy. The little girl, one year and five months old, had to undergo a transplant quickly, but the rhino-pharyngeal swabs to which she was subjected over the last few months continued to give the same positive response to the virus. "We had no choice, so we took courage and decided to go ahead", explains Veronica Tintori, head of the hematopoietic transplant section of the Center of Excellence for Oncology and Hematology, directed by Claudio Favre. (Continued). The child, according to a note from Meyer, had a very rapid recovery and was able to return home, even negativized. The little girl will now have to follow a tight path of treatments and controls to monitor the progress of the oncological pathology, but her recovery represents a great goal.


In March, at the height of the coronavirus epidemiological emergency, tests revealed that the little patient had also been infected. As often happens in children, the disease had a mild course, without any particular complications. But in the following months, the little girl never felt negative, even if the doctors tried every way, even using two hyperimmune plasma treatments.



When the summer arrived, the doctors decided that the transplant could no longer wait: the form was too aggressive and the risk that the situation would degenerate further was too high. As it was not possible to select a donor from the registry, the doctors decided to use the haploidentical father, that is, 50% compatible, and the process began.



"The peculiarity of this transplant - concludes Favre - was having started it with the baby still positive for Covid-19 and in the absence of a healing immune response. We found ourselves starting the transplant procedure in a clinical condition comparable to a bad one. influenza: in these cases the transplant is usually postponed. Since it is Covid-19 the risk of serious complications was far higher. A decision therefore very painful and discussed several times by our entire group of oncohematologists from Meyer. as far as we know, no cases of this type were described and we did not know how the child could have reacted. Before proceeding, we also heard the non-binding opinion of the scientific commission of Gitmo (Italian bone marrow transplant group) and asked for the opinion to numerous international experts ".