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Griffin M, Eikema DJ, Verheggen I, Kulagin A, Tjon JML, Fattizzo B, Ingram W, Zaidi U, Desnica L, Giammarco S, Drozd-Sokolowska J, Xicoy B, Patriarca A, Loschi M, Szmigielska-Kaplon A, Beier F, Cignetti A, Drexler B, Gavriilaki E, Lanza F, Orvain C, Risitano AM, De la Camara R, De Latour RP. SARS-CoV-2 vaccination in 361 non-transplanted patients with aplastic anemia and/or paroxysmal nocturnal hemoglobinuria. Haematologica 2024; 109:283-286. [PMID: 37584297 PMCID: PMC10772488 DOI: 10.3324/haematol.2023.283863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/10/2023] [Indexed: 08/17/2023] Open
Affiliation(s)
| | | | | | - Alexander Kulagin
- RM Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russian Federation
| | | | - Bruno Fattizzo
- SC Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
| | | | - Uzma Zaidi
- National Institute of Blood Disease and Bone Marrow Transplantation, Karachi
| | | | - Sabrina Giammarco
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
| | | | - Blanca Xicoy
- Institut Català d'Oncologia-Hospital Universitari Germans Trias i Pujol; Josep Carreras Leukemia Research Institute, Barcelona
| | - Andrea Patriarca
- Azienda Ospedaliero-Universitaria Maggiore della Carità and translational medicine department University of Eastern Piedmont, Novara
| | | | | | - Fabian Beier
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, RWTH Aachen University, Aachen
| | | | | | | | - Francesco Lanza
- Metropolitan Transplant Network, Hospital Santa Maria delle Croci, Ravenna, Italy 21: Centre Hospitalier Universitaire d'Angers, Angers
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2
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Chatzikalil E, Kattamis A, Diamantopoulos P, Solomou EE. New-onset aplastic anemia after SARS-CoV-2 vaccination. Int J Hematol 2023; 118:667-681. [PMID: 37768509 DOI: 10.1007/s12185-023-03666-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/02/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023]
Abstract
Aplastic anemia (AA) is a rare autoimmune disease. Drugs, viruses, and radiation are among the most common etiologic factors, and most cases have immune pathophysiology. SARS-CoV-2 vaccines have been linked with rare side effects, including cases of acquired aplastic anemia. Here we review all the reported cases of new-onset AA after SARS-CoV-2 vaccination, and discuss their clinical characteristics and management. 18 patients in these case reports had a median age of 58 years. The time from vaccination to onset of aplastic anemia ranged from 1 day to 7 months, with a median of 2.5 weeks. Seventeen patients were diagnosed with severe or very severe aplastic anemia post-vaccination and all patients received standard treatments for acquired aplastic anemia. Seventeen patients achieved a complete or partial response and only 1 patient died. Aplastic anemia can be considered a very rare SARS-CoV-2 vaccine-related adverse event, although a causative relationship has not been proven. Reporting cases of such uncommon post-vaccination events could help clinicians to consider aplastic anemia when pancytopenia is observed after vaccination. The benefits of SARS-Cov-2 vaccination are established, and reports of rare events serve only to increase awareness in daily clinical practice.
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Affiliation(s)
- Elena Chatzikalil
- Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Antonis Kattamis
- Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Panagiotis Diamantopoulos
- First Department of Internal Medicine, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Elena E Solomou
- Internal Medicine-Hematology, University of Patras Medical School, 26500, Rion, Greece.
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Wu X, Mo Y, Wen K, Ming R, Yin X, Hu L, Liu G, Lin G, Li W. Acquired aplastic anaemia after SARS-CoV-2 infection in China: a case report. Front Pediatr 2023; 11:1277540. [PMID: 38027266 PMCID: PMC10661920 DOI: 10.3389/fped.2023.1277540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Since the coronavirus disease 2019 (COVID-19) pandemic began, several research groups in different countries have described cases of aplastic anaemia (AA) after COVID-19 or COVID-19 vaccination. Here, we present the case of a patient with new-onset AA in Changsha, China, that was presumably associated with preceding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We conducted an epidemiological assessment of the incidence rate of blood system diseases from July 1, 2022, to May 31, 2023, in the haematology department of the Second Xiangya Hospital of Central South University and Hunan Children's Hospital. The detection rates of AA and leukaemia in the first two months after the epidemic outbreak were higher than those before and during the outbreak. However, only the difference in the detection rate of leukaemia was statistically significant.
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Affiliation(s)
- Xiyan Wu
- Center for Reproductive Medicine, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
| | - Yi Mo
- Department of Laboratory Medicine, Hunan Children’s Hospital, Changsha, China
| | - Kailiang Wen
- Medical Laboratory, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Rui Ming
- The Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
| | - Xinyu Yin
- The Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
| | - Liang Hu
- The Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
| | - Gang Liu
- The Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
| | - Ge Lin
- The Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
| | - Weina Li
- Department of Andrology, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, China
- Scientific Research Department, Hunan Guangxiu Hi-Tech Life Technology Co., Ltd., Changsha, China
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4
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Kobayashi M, Mori A, Oda Y, Yokoyama E, Kanaya M, Izumiyama K, Saito M, Tanaka S, Morioka M, Kondo T. New onset of hypomegakaryocytic thrombocytopenia with the potential for progression to aplastic anemia after BNT162b2 mRNA COVID-19 vaccination. Int J Hematol 2023; 118:477-482. [PMID: 37219678 PMCID: PMC10203663 DOI: 10.1007/s12185-023-03618-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 05/24/2023]
Abstract
Vaccination with a coronavirus disease-2019 (COVID-19) vaccine is an effective public health measure for reducing the risk of infection and severe complications from COVID-19. However, serious hematological complications after COVID-19 vaccination have been reported. Here, we report a case of new-onset hypomegakaryocytic thrombocytopenia (HMT) with the potential for progression to aplastic anemia (AA) that developed in a 46-year-old man 4 days after the fourth mRNA COVID-19 vaccination. Platelet count rapidly decreased after vaccination and white blood cell count declined subsequently. Bone marrow examination immediately after disease onset showed severely hypocellular marrow (cellularity of almost 0%) in the absence of fibrosis, findings that were consistent with AA. Since the severity of pancytopenia did not meet the diagnostic criteria for AA, the patient was diagnosed with HMT that could progress to AA. Treatment with eltrombopag and cyclosporine was started immediately after diagnosis and cytopenia improved. Although it is difficult to determine whether the post-vaccination cytopenia was vaccine induced or accidental because the association was chronological, vaccination with an mRNA-based COVID-19 vaccine may be associated with development of HMT/AA. Therefore, physicians should be aware of this rare, but serious adverse event and promptly provide appropriate treatment.
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Affiliation(s)
- Mirei Kobayashi
- Blood Disorders Center, Aiiku Hospital, S4W25, Chuo-ku, Sapporo, 064-0804, Japan.
| | - Akio Mori
- Blood Disorders Center, Aiiku Hospital, S4W25, Chuo-ku, Sapporo, 064-0804, Japan
| | - Yoshitaka Oda
- Department of Cancer Pathology, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Emi Yokoyama
- Blood Disorders Center, Aiiku Hospital, S4W25, Chuo-ku, Sapporo, 064-0804, Japan
| | - Minoru Kanaya
- Blood Disorders Center, Aiiku Hospital, S4W25, Chuo-ku, Sapporo, 064-0804, Japan
| | - Koh Izumiyama
- Blood Disorders Center, Aiiku Hospital, S4W25, Chuo-ku, Sapporo, 064-0804, Japan
| | - Makoto Saito
- Blood Disorders Center, Aiiku Hospital, S4W25, Chuo-ku, Sapporo, 064-0804, Japan
| | - Shinya Tanaka
- Department of Cancer Pathology, Faculty of Medicine, Hokkaido University, Sapporo, Japan
- Institute for Chemical Reaction Design and Discovery (WPI-ICReDD), Hokkaido University, Sapporo, Japan
| | - Masanobu Morioka
- Blood Disorders Center, Aiiku Hospital, S4W25, Chuo-ku, Sapporo, 064-0804, Japan
| | - Takeshi Kondo
- Blood Disorders Center, Aiiku Hospital, S4W25, Chuo-ku, Sapporo, 064-0804, Japan
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Pvs S, Koka H, Suvvari TK, Mounish Reddy B, Godavari ST, Thomas V. An Unusual Case of Acquired Aplastic Anemia following SARS-CoV-2 Vaccination: A Case Report. IDCases 2023; 33:e01826. [PMID: 37360926 PMCID: PMC10279557 DOI: 10.1016/j.idcr.2023.e01826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023] Open
Abstract
Aplastic Anemia (AA) is a condition where the body's immune system attacks and destroys the hematopoietic stem cells, leading to pancytopenia and an empty bone marrow. AA can be effectively treated using immunosuppressive therapy or hematopoietic stem-cell transplantation. The damage to stem cells in the bone marrow can be due to several causes, such as autoimmune diseases, medication like cytotoxic drugs and antibiotics, and exposure to toxins or chemicals in the environment. In this case report, we present the diagnosis and treatment of a 61-year-old man who was diagnosed with Acquired Aplastic Anemia, which could have developed following his serial immunizations with the SARS-CoV-2 COVISHIELD viral vector vaccine. The patient received immunosuppressive therapy consisting of cyclosporine, anti-thymocyte globulin, and prednisone, resulting in a significant improvement in his condition.
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Affiliation(s)
- Smruthi Pvs
- GSL Medical College & General Hospital, Rajahmundry, Andhra Pradesh, India
| | | | - Tarun Kumar Suvvari
- Rangaraya Medical College, Kakinada, Andhra Pradesh, India
- Squad Medicine and Research (SMR), India
| | - B Mounish Reddy
- GSL Medical College & General Hospital, Rajahmundry, Andhra Pradesh, India
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Ang SY, Huang YF, Chang CT. Ph-Positive B-Cell Acute Lymphoblastic Leukemia Occurring after Receipt of Bivalent SARS-CoV-2 mRNA Vaccine Booster: A Case Report. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59030627. [PMID: 36984629 PMCID: PMC10054610 DOI: 10.3390/medicina59030627] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is a universal emergency public health issue. A large proportion of the world's population has had several spike antigen exposures to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and/or COVID-19 vaccinations in a relatively short-term period. Although sporadic hematopoietic adverse events after COVID-19 vaccine inoculation were reported, there is currently no sufficient evidence correlating anti-spike protein immune responses and hematopoietic adverse events of vaccinations. We reported the first case of Ph-positive B-cell acute lymphoblastic leukemia (ALL) occurring after a bivalent mRNA COVID-19 vaccine inoculation. The otherwise healthy 43-year-old female patient had a total of six spike antigen exposures in the past 1.5 years. Informative pre-vaccine tests and bone marrow study results were provided. Although the causal relationship between bivalent vaccinations and the subsequent development of Ph-positive B-cell ALL cannot be determined in the case report, we propose that anti-spike protein immune responses could be a trigger for leukemia. Clinicians must investigate the hematopoietic adverse events closely after COVID-19 vaccinations. Further pre-clinical studies to investigate the safety of bivalent mRNA COVID-19 vaccine are required.
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Affiliation(s)
- Shy-Yau Ang
- Department of Emergency Medicine, Far Eastern Memorial Hospital, No.21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City 22056, Taiwan
| | - Yi-Fang Huang
- Department of General Dentistry, Chang Gung Memorial Hospital, Linkou 33305, Taiwan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Chung-Ta Chang
- Department of Emergency Medicine, Far Eastern Memorial Hospital, No.21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City 22056, Taiwan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan 32003, Taiwan
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