As the global COVID-19 vaccination campaign progresses, the pandemic situation in some countries and regions has gradually come under control. Naturally, concerns regarding vaccine side effects remain a focal point of public attention.
Recently,NatureSister JournalNature Medicine`revealed a ... by`Pfizer/BioNTechCOVID-19mRNA vaccineBNT162b2-associatedVery rare adverse events. ALong-term anti-PD-1 monotherapyofColorectal cancer patients`After receiving this vaccine, the following occurs in the body:`Cytokine Storm. This is alsoFirst Globally Reported Cytokine Storm Induced by mRNA COVID-19 Vaccine。
https://doi.org/10.1038/s41591-021-01387-6
Cytokine storm, i.e.,Cytokine Release Syndrome (CRS), is an immune system "indiscriminate attack" triggered by intense stimuli such as bacteria and viruses, manifesting as a systemic inflammatory response. In patients with novel coronavirus pneumonia (COVID-19), CRS is a critical factor driving disease progression to severe and critical stages.
The main subject of this report is a58 years oldofMale, fromStarted anti-PD-1 therapy in February 2019to treat colorectal cancer, during which anti-PD-1 therapy was interrupted due to immune-related adverse events.On December 29, 2020, 27 days after receiving anti-PD-1 monotherapy, this patient received the first dose of the Pfizer mRNA vaccine.。
In5 days after vaccination, i.e.,Day 32 of Anti-PD-1 TherapyAfterwards, thisThe patient began to develop symptoms of fever, diarrhea, and myalgia., admission laboratory tests revealed a C-reactive protein (CRP) level of 125 mg/L and thrombocytopenia (platelet count of 68 × 10^9/L). RT-PCR test results indicated that the patient was negative for COVID-19.
Over the following 5 days, the patient's condition deteriorated, with body temperature reaching 39.8°C, platelet count further decreasing to 28 × 10^9/L, CRP levels rising to 317 mg/L, serum lactate dehydrogenase (LDH) levels associated with organ damage surging from a previous 184 U/L to 849 U/L, and ferritin levels reaching 6,010 µg/L (normal range: 18–464 µg/L).
Clinical Course of Cancer Diagnosis and Inflammatory Markers During CRS
Based on these data, the healthcare providers suspected that this patient might be experiencing CRS (Grade 3), and therefore, starting on January 1, 2021, initiated [treatment] for him.`Intravenous methylprednisolone`(IVMP), and 7 days later, the patient's biochemical and hematological parameters returned to normal levels.Longitudinal cytokine analysis before and after IVMP treatment revealed persistent activation of patient T cells, confirming the occurrence of CRS.
Cytokine Level Test Results
On February 8, 2021, the patient resumed anti-PD-1 therapy, and no adverse reactions were clinically observed. To date, the patient has not received a second dose of the mRNA vaccine.
In conclusion, this report indicates,Anti-PD-1 drugs may be a potential contributing factor to CRS in cancer patients following COVID-19 vaccination.. Researchers believe that,Given that cancer patients were not previously included in clinical trials for COVID-19 vaccines but are prioritized in vaccination programs, it is necessary to obtain additional prospective pharmacodynamic data. Nevertheless, as one of the populations more susceptible to COVID-19, cancer patients should still be prioritized for vaccination.。
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