COVID-19 and Multiple Myeloma: Effects of IL-6 Blockade
Posted: Monday, June 8, 2020
According to Aristeidis Chaidos, MD, PhD, of the Imperial College London, United Kingdom, treatment with the monoclonal-antibody tocilizumab appears to improve outcomes for patients with multiple myeloma and COVID-19. Two patient profiles, which were published in the British Journal of Haematology, suggest this anti–interleukin-6 (IL-6) drug may prevent COVID-19 progression by suppressing the inflammatory response.
“Tocilizumab engages both the soluble and membrane-bound IL-6R with complete IL-6 signaling blockade, resulting in [the] rapid resolution of fever, respiratory distress, and hypotension in cytokine-release syndrome,” the authors remarked. “A favorable safety profile further supports the rationale for its use in COVID-19.”
The first patient, a 66-year-old man undergoing third-line lenalidomide-based therapy for relapsing multiple myeloma, presented with a fever, dry cough, and hypoxia. Based upon the results of a chest radiograph, he was diagnosed with COVID-19. The patient was given two doses of tocilizumab intravenously, and his condition rapidly improved. Furthermore, laboratory assessments revealed his levels of inflammatory markers, such as C-reactive protein and serum ferritin, were gradually returning to baseline. He was subsequently discharged from the hospital 8 days later.
The second patient, a 59-year-old man undergoing fourth-line therapy with bortezomib and panobinostat for treatment of relapsing multiple myeloma, was admitted after experiencing a fever, hypoxia, and abnormal respiration. After being diagnosed with COVID-19, the patient was put on a ventilator and administered two doses of tocilizumab intravenously. His inflammatory marker levels decreased rapidly; however, recovery of his respiratory function was gradual. After 24 days, the patient underwent a tracheostomy, and his physicians began to wean him off organ support therapy.
“Early intervention with IL-6 blockade may prevent progression to critical disease and escalation to invasive ventilation,” the authors proposed.
Disclosure: For full disclosures of the study authors, visit www.onlinelibrary.wiley.com.
