From an evolutionary point of view, the primary function of the immune system was to safeguard the host from pathogens. The immune system's discriminatory functions have been shaped by selective pressures, which constantly balance the killing of pathogens with protecting host tissues. The immune system plays a crucial role in antitumor immunity as well as protecting against microbial pathogens. A wide range of hematologic disorders are characterized by immune dysfunction, which can be under- or overactive. In this section, we go over the fundamental aspects of the immune system as well as the key ideas that are necessary for comprehending how immune dysfunction affects hematologic disorders. Medical and scientific efforts to comprehend the biological basis of COVID-19 pathophysiological mechanisms have been prompted by the ongoing pandemic of Corona Virus Disease 2019 (COVID-19), which was brought on by the Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2). As a result, evaluating the risks associated with COVID-19 infection and the efficacy of its management may benefit from an examination of a variety of immunological and haematological parameters. A 70-year-old man, who was previously in good health, presents with six weeks of stifling night sweats and fatigue. Lymphadenopathy in the inguinal, axillary, and cervical regions stands out during the physical exam. For mild anemia and an elevated lactate dehydrogenase level, laboratory studies are important. A lymph node biopsy reveals CD20+CD10+Bcl6+ large B cells, indicating a germinal center subtype of diffuse large B-cell lymphoma. He goes into complete remission after undergoing immunochemotherapy with rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone, also known as R-CHOP, for six cycles. However, despite salvage immunochemotherapy, his lymphoma recurs within six months and progresses. He then discusses with his hematologist the pros and cons of a Bispecific T-Cell Engager (BiTE) clinical trial versus Chimeric Antigen Receptor T Cell (CAR-T) therapy.
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