A case study has revealed that the immunosuppressant tocilizumab could be an effective treatment for severe COVID-19 in patients who have multiple myeloma or other blood cancers
The case involved a 60-year-old man in Wuhan, China. The details were published in the journal Blood Advances.
The patient, who has had multiple myeloma since 2015, tested positive for the coronavirus after being taken to hospital in February with a tight chest and shortness of breath. He did not have the typical symptoms of a cough or fever, but his illness was classified as severe.
The doctors describe how he failed to respond fully to antiviral and corticosteroid therapies. On the second day in hospital, a chest CT scan showed that the patient had ground glass opacities in his lungs, a sign of pneumonia.
He was given one intravenous administration of tocilizumab because his levels of interleukin-6 (IL-6) were high, after which his IL-6 levels decreased. Three days after tocilizumab treatment, his chest tightness had resolved and 10 days later, his CT scan had cleared, and he was discharged from the hospital.
Study leader Dr Changcheng Zheng, of the University of Science and Technology of China, said: “Our patients with haematologic malignancies are immunosuppressed, which may put them at higher risk for novel coronavirus infection.”
Dr Zheng and his team suggest that tocilizumab, which is used to treat cytokine release syndrome, could address the cytokine storm that the virus triggers. However, they say that more research is needed into the potential mechanisms of action.
The team also said because the patient had chest tightness and shortage of breath without other COVID-19 symptoms, clinical symptoms of the virus may not be typical in patients who have hematologic malignancies.
Last month (March 2020), the US Food and Drug Administration approved a randomised, double-blind, placebo-controlled phase III clinical trial to evaluate the safety and efficacy of intravenous tocilizumab for the treatment of adult patients with COVID-19.
Zhang X, Song K, Tong F, Fei M, Guo H, Lu Z, Wang J, Zheng C (2020) “First case of COVID-19 in a patient with multiple myeloma successfully treated with tocilizumab”, Blood Advances, doi: 10.1182/bloodadvances.2020001907
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