PMID- 34797216
OWN - NLM
STAT- Publisher
LR  - 20240220
IS  - 1588-2640 (Electronic)
IS  - 1217-8950 (Linking)
DP  - 2021 Nov 19
TI  - Common points of therapeutic intervention in COVID-19 and in allogeneic 
      hematopoietic stem cell transplantation associated severe cytokine release 
      syndrome.
LID - 10.1556/030.2021.01620 [doi]
AB  - Allogeneic hematopoietic stem cell transplantation (HSCT) and coronavirus disease 
      2019 (COVID-19) infection can both lead to severe cytokine release syndrome 
      (sCRS) resulting in critical illness and death. In this single institution, 
      preliminary comparative case-series study we compared clinical and laboratory 
      co-variates as well as response to tocilizumab (TCZ)-based therapy of 15 
      allogeneic-HSCT- and 17 COVID-19-associated sCRS patients. Reaction to a TCZ plus 
      posttransplant cyclophosphamide (PTCY) consolidation therapy in the 
      allogeneic-HSCT-associated sCRS group yielded significantly inferior long-term 
      outcome as compared to TCZ-based therapy in the COVID-19-associated group (P = 
      0.003). We report that a TCZ followed by consolidation therapy with a Janus 
      kinase/signal transducer and activator of transcription (JAK/STAT) inhibitor 
      given to 4 out of 8 critically ill COVID-19 patients resulted in their complete 
      recovery. Non-selective JAK/STAT inhibitors influencing the action of several 
      cytokines exhibit a broader effect than TCZ alone in calming down sCRS. Serum 
      levels of cytokines and chemokines show similar changes in allogeneic-HSCT- and 
      COVID-19-associated sCRS with marked elevation of interleukin-6 (IL-6), regulated 
      upon activation normal T-cell expressed and secreted (RANTES), monocyte 
      chemoattractant protein-1 (MCP-1) and interferon gamma-induced protein 10 kDa (IP-10) 
      levels. In addition, levels of IL-5, IL-10, IL-15 were also elevated in 
      allogeneic-HSCT-associated sCRS. Our multi-cytokine expression data indicate that 
      the pathophysiology of allogeneic-HSCT and COVID-19-associated sCRS are similar 
      therefore the same clinical grading system and TCZ-based treatment approaches can 
      be applied. TCZ with JAK/STAT inhibitor consolidation therapy might be highly 
      effective in COVID-19 sCRS patients.
FAU - Gopcsa, Laszlo
AU  - Gopcsa L
AUID- ORCID: 0000-0003-4930-7049
AD  - 1Central Hospital of Southern-Pest, National Institute of Hematology and 
      Infectious Diseases, Department of Hematology and Stem Cell Transplantation, 
      Albert Florian ut 5-7, H-1097, Budapest, Hungary.
FAU - Bobek, Ilona
AU  - Bobek I
AD  - 2Central Hospital of Southern-Pest, National Institute of Hematology and 
      Infectious Diseases, Department of Intensive Care Unit, Albert Florian ut 5-7, 
      H-1097, Budapest, Hungary.
FAU - Beko, Gabriella
AU  - Beko G
AD  - 3Central Hospital of Southern-Pest, National Institute of Hematology and 
      Infectious Diseases, Department of Central Laboratory, Albert Florian ut 5-7, 
      H-1097, Budapest, Hungary.
FAU - Lakatos, Botond
AU  - Lakatos B
AD  - 4Central Hospital of Southern-Pest, National Institute of Hematology and 
      Infectious Diseases, Department of Infectious Diseases, Albert Florian ut 5-7, 
      H-1097, Budapest, Hungary.
FAU - Molnar, Eszter
AU  - Molnar E
AD  - 2Central Hospital of Southern-Pest, National Institute of Hematology and 
      Infectious Diseases, Department of Intensive Care Unit, Albert Florian ut 5-7, 
      H-1097, Budapest, Hungary.
FAU - Reti, Marienn
AU  - Reti M
AD  - 1Central Hospital of Southern-Pest, National Institute of Hematology and 
      Infectious Diseases, Department of Hematology and Stem Cell Transplantation, 
      Albert Florian ut 5-7, H-1097, Budapest, Hungary.
FAU - Remenyi, Peter
AU  - Remenyi P
AD  - 1Central Hospital of Southern-Pest, National Institute of Hematology and 
      Infectious Diseases, Department of Hematology and Stem Cell Transplantation, 
      Albert Florian ut 5-7, H-1097, Budapest, Hungary.
FAU - Sinko, Janos
AU  - Sinko J
AD  - 1Central Hospital of Southern-Pest, National Institute of Hematology and 
      Infectious Diseases, Department of Hematology and Stem Cell Transplantation, 
      Albert Florian ut 5-7, H-1097, Budapest, Hungary.
FAU - Szlavik, Janos
AU  - Szlavik J
AD  - 4Central Hospital of Southern-Pest, National Institute of Hematology and 
      Infectious Diseases, Department of Infectious Diseases, Albert Florian ut 5-7, 
      H-1097, Budapest, Hungary.
FAU - Tatai, Gabor
AU  - Tatai G
AD  - 1Central Hospital of Southern-Pest, National Institute of Hematology and 
      Infectious Diseases, Department of Hematology and Stem Cell Transplantation, 
      Albert Florian ut 5-7, H-1097, Budapest, Hungary.
FAU - Valyi-Nagy, Istvan
AU  - Valyi-Nagy I
AD  - 1Central Hospital of Southern-Pest, National Institute of Hematology and 
      Infectious Diseases, Department of Hematology and Stem Cell Transplantation, 
      Albert Florian ut 5-7, H-1097, Budapest, Hungary.
LA  - eng
PT  - Journal Article
DEP - 20211119
PL  - Hungary
TA  - Acta Microbiol Immunol Hung
JT  - Acta microbiologica et immunologica Hungarica
JID - 9434021
SB  - IM
OTO - NOTNLM
OT  - CAR-T-cell
OT  - COVID-19
OT  - allogeneic-HSCT
OT  - multi-cytokine levels
OT  - severe CRS therapy
EDAT- 2021/11/20 06:00
MHDA- 2021/11/20 06:00
CRDT- 2021/11/19 12:13
PHST- 2021/10/03 00:00 [received]
PHST- 2021/10/22 00:00 [accepted]
PHST- 2021/11/19 12:13 [entrez]
PHST- 2021/11/20 06:00 [pubmed]
PHST- 2021/11/20 06:00 [medline]
AID - 10.1556/030.2021.01620 [doi]
PST - aheadofprint
SO  - Acta Microbiol Immunol Hung. 2021 Nov 19. doi: 10.1556/030.2021.01620.