SARS-CoV-2 Interstitial Pneumonia Treated With Tocilizumab in a Patient Affected by Classical Hodgkin Lymphoma

摘要

The World Health Organization on March 2020 declared the novel coronavirus SARS-CoV-2 pandemic. Corona Virus Infectious Disease 19 (COVID-19) affects a wide range of patients, from asymptomatic to seriously compromised ones, displaying very heterogeneous clinical features. Severe cases may present with multiple organ dysfunctions, among which acute respiratory distress syndrome (ARDS) represents the principal cause of death. Excessive immune responses leading to a cytokine storm play a crucial role in lung damage progression, with interleukine 6 (IL-6) being one of the pivotal cytokines involved.1 Hence, blockade of IL-6 signaling might represent a promising approach to treat COVID-19-related ARDS. Tocilizumab, a humanized monoclonal antibody against IL-6 receptor (IL-6R), has been previously described as a potential effective treatment option in seriously non-cancer COVID-19 patients.2,3 Cancer patients are considered at higher risk of SARS-CoV-2 infection than general population, and their prognosis has been described as poorer.4 In the oncological setting, hematological cancer patients are expected to be particularly susceptible to infections, due to malignancy-and therapy-related immunodeficiencies. A recent report highlights a very high mortality in an heterogeneous hematological cohort.5 Very few preliminary data are available on the efficacy of tocilizumab for COVID-19 treatment in solid and hematological cancer patients.5,6,7 We therefore report a case of SARS-CoV-2 interstitial pneumonia in a patient with classical Hodgkin Lymphoma (cHL) successfully treated with tocilizumab.