Management of acute promyelocytic leukemia in the setting of acute COVID-19 infection

Abstract

Acute promyelocytic leukemia (APL) often presents with significant coagulopathy which may result in both hemorrhagic and thrombotic complications. The emergence of the COVID-19 pandemic has complicated the initial treatment and diagnosis of APL owing to the viral infection's own associated coagulopathy. Here we report two cases of APL newly diagnosed in the setting of COVID-19 infection and considerations in their management. Included is a discussion of strategies for the dosing of arsenic trioxide in patients with significant obesity and renal insufficiency.The case series submitted does not represent a study on patients and thus no specific informed consents or permissions were required. All images included in our manuscript have been deidentified and all authors certify that personal details that could potentially be used to identify the patients in the cases described have been removed. The corresponding author has personally confirmed that both patients included in this study have given verbal permission to present their cases in the de-identified manner as described above.

Keywords

• Acute promyelocytic leuekemia
• COVID-19
• Arsenic trioxide
• Differentiation syndrome