Cytokine release syndrome in a patient with colorectal cancer after vaccination with BNT162b2.
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Date
2021-05-26Author
Au, L
Fendler, A
Shepherd, STC
Rzeniewicz, K
Cerrone, M
Byrne, F
Carlyle, E
Edmonds, K
Del Rosario, L
Shon, J
Haynes, WA
Ward, B
Shum, B
Gordon, W
Gerard, CL
Xie, W
Joharatnam-Hogan, N
Young, K
Pickering, L
Furness, AJS
Larkin, J
Harvey, R
Kassiotis, G
Gandhi, S
Crick COVID-19 Consortium,
Swanton, C
Fribbens, C
Wilkinson, KA
Wilkinson, RJ
Lau, DK
Banerjee, S
Starling, N
Chau, I
CAPTURE Consortium,
Turajlic, S
Type
Journal Article
Metadata
Show full item recordAbstract
Patients with cancer are currently prioritized in coronavirus disease 2019 (COVID-19) vaccination programs globally, which includes administration of mRNA vaccines. Cytokine release syndrome (CRS) has not been reported with mRNA vaccines and is an extremely rare immune-related adverse event of immune checkpoint inhibitors. We present a case of CRS that occurred 5 d after vaccination with BTN162b2 (tozinameran)-the Pfizer-BioNTech mRNA COVID-19 vaccine-in a patient with colorectal cancer on long-standing anti-PD-1 monotherapy. The CRS was evidenced by raised inflammatory markers, thrombocytopenia, elevated cytokine levels (IFN-γ/IL-2R/IL-18/IL-16/IL-10) and steroid responsiveness. The close temporal association of vaccination and diagnosis of CRS in this case suggests that CRS was a vaccine-related adverse event; with anti-PD1 blockade as a potential contributor. Overall, further prospective pharmacovigillence data are needed in patients with cancer, but the benefit-risk profile remains strongly in favor of COVID-19 vaccination in this population.
Collections
Subject
Crick COVID-19 Consortium
CAPTURE Consortium
Language
eng
Date accepted
2021-05-07
License start date
2021-05-26
Citation
Nature medicine, 2021
Publisher
NATURE PORTFOLIO