A Fatal Breakthrough Coronavirus Disease 2019 Case Following Bendamustine–Rituximab Therapy

Abstract

Although messenger ribonucleic acid vaccines are substantially effective toward severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, patients with hematological 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 serological 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.