Risk of coronavirus disease 2019 (COVID-19) infection on leukemia patients: basic science to clinical aspect
Abstract
In March 2020, the Coronavirus disease 2019 (COVID-19) pandemic was announced by the World Health Organization (WHO). A novel strain of coronavirus, recently named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) created the disease, which showed symptoms similar to SARS. The virus's bond determines its pathogenesis with its host's cell receptors, mainly the Angiotensin-Converting Enzyme 2 (ACE2). It is a factor of the Renin-Angiotensin System (RAS), that holds a vital function in hematopoiesis of hematologic malignancies. There is mRNA expression of the RAS component, so there is an increase in ACE2 levels in patients with leukemia, primarily the myeloid type. Acute Myeloid Leukemia (AML) malignant blood cells can escape from the immune system through a biochemical mechanism that causes AML cells to deactivate Natural Killer (NK) and cytotoxic lymphoid cells (cytotoxic T cells (CTC). This review article aims to explain the molecular mechanism, including leukemia patients' immune system with COVID-19 and recommendations for patients and hemato-oncologists.
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