Successful COVID-19 Treatment Reported in a Patient With Multiple Myeloma
Posted: Friday, April 10, 2020
The journal Blood Advances described reportedly the first successful treatment of a patient with multiple myeloma infected with the 2019 novel coronavirus (COVID-19). Changcheng Zheng, MD, of The First Affiliated Hospital of the University of Science and Technology of China, and colleagues reported on the effectiveness of administering the immunosuppressant tocilizumab in reducing COVID-19 symptoms. In addition, the authors suggest validating the safety and efficacy of tocilizumab through future clinical trials.
“Our patients with hematologic malignancies are immunosuppressed, which may put them at higher risk for novel coronavirus infection,” said Dr. Zheng in an American Society of Hematology press release.
A 60-year-old man in Wuhan, China, presented to a local hospital complaining of chest tightness. In 2015, the patient was diagnosed with multiple myeloma. Treatment involved induction chemotherapy (bortezomib, thalidomide, and dexamethasone) with thalidomide-based treatment for maintenance.
Upon admission, the patient was initially treated with 400 mg of IV moxifloxacin for 3 days. Despite an absence of fever and cough, CT chest scans showed bilateral, multiple ground-glass opacities in subpleural spaces—consistent with COVID-19. Nasopharyngeal swabs confirmed a positive diagnosis for COVID-19, and the patient was subsequently prescribed 200 mg of umifenovir. In addition, the patient was given 40 mg of IV methylprednisolone daily for 4 days along with oxygen supplementation. Although oxygen saturation improved to 96%, the patient continued to report chest tightness. Additional testing revealed no change in the lungs and high levels of serum interleukin-6 (IL-6).
On the ninth day, the patient was administered a single IV dose of 8 mg/kg of tocilizumab. After 3 days, the chest tightness disappeared, and IL-6 levels fluctuated for 10 days before gradually decreasing to 117.10 pg/mL. A third CT scan confirmed a reduction in ground-glass opacities, and the patient was discharged.
Disclosure: The study authors reported no conflicts of interest.
