CML AND COVID-19: Case Report of Successful Treatment With Tocilizumab
Posted: Tuesday, August 11, 2020
In a case study presented in the British Journal of Haematology, the monoclonal antibody tocilizumab was used successfully to treat cytokine-release syndrome associated with COVID-19 in a patient with poorly controlled chronic myeloid leukemia (CML), despite compliance with imatinib. Investigative therapies such as tocilizumab should be “actively pursued,” noted Ruby Haji, MD, of the Hillingdon Hospitals NHS Foundation Trust, Uxbridge, United Kingdom, and colleagues.
“Therapies such as this have the potential to change the outcome of severe COVID‐19 infection and prevent ICU admission, particularly in patients believed to be unsuitable for critical care or where there is a great demand on critical care resources,” the authors concluded.
A 52-year-old man with poorly controlled CML tested positive for COVID-19 after being admitted to the emergency department because of an ongoing fever and breathlessness. The man was treated with the antiviral therapies liponavir and ritonavir after being invited into the RECOVERY trial, which tested the outcomes of tocilizumab in this patient population. Ten days after diagnosis, the man underwent a CT pulmonary angiogram because of his increased oxygen requirements and elevated D-dimer.
The man’s health continued to deteriorate, until on day 12 of the illness, he received 600 mg of tocilizumab intravenously, in line with the RECOVERY trial dosing protocol. The authors noted rapid cessation of the patient’s fever and significant reduction in inflammatory markers within 24 hours of receiving tocilizumab. The man was weaned off continuous positive airway pressure, as his oxygen requirement improved, and discontinued therapy with supplementary oxygen 19 days after diagnosis.
Disclosure: For full disclosure of the study authors, visit wiley.com.