To remember

Chinese investigators have reported the first successful use of tocilizumab to treat 2019 coronavirus disease (COVID-19) in a patient with multiple myeloma (MM).

Why is it important?

Severe forms of COVID-19 may involve an intense immune response and “cytokine shock”.

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Principle results

A 60-year-old man was hospitalized in Wuhan, China.

Symptoms: chest tightness without fever and cough.

Thoracic computed tomography (CT): multiple opacities in frosted glass and a pneumatocele in the subpleural spaces.

After 3 days, he tested positive for COVID-19 and treatment with umifenovir 200 mg orally 3 times a day was started.

The patient had a history of symptomatic MM diagnosed in 2015 and treated with 2 cycles of induction chemotherapy and thalidomide maintenance therapy.

On day 9 of hospital, he received a single intravenous dose of 8 mg / kg of tocilizumab.

On day 12, the chest tightness disappeared.

Over a 10-day period, her interleukin-6 level initially decreased, then rapidly increased to a peak (following the recovery of T cells), eventually decreasing to a low level.

On day 19, chest CT revealed an obvious reduction in several frosted glass opacities.

When he was discharged from the hospital, he had no symptoms of MM, and the results of the laboratory tests were within normal ranges.

References Disclaimer

Zhang X, Song K, Tong F, Fei M, Guo H, Lu Z, Wang J, Zheng C. First
case of COVID-19 in a patient with multiple myeloma successfully treated with tocilizumab. Blood Adv. 2020; 4 (7): 1307-1310. doi:
10.1182 / bloodadvances.2020001907. PMID: 32243501

MDedge. First report of MM patient successfully treated for COVID-19 with tocilizumab. 6 April 2020.

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