Cytokine release syndrome in a patient with colorectal cancer after vaccination with BNT162b2
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Lewis Au Annika Fendler Scott TC Shepherd Karolina Rzeniewicz Maddalena Cerrone Fiona Byrne Eleanor Carlyle Kim Edmonds Lyra Del Rosario John Shon Winston A Haynes Barry Ward Ben Shum William Gordon Camille L Gerard Wenyi Xie Nalinie Joharatnam-Hogan Kate Young Lisa Pickering Andrew JS Furness James Larkin Ruth Harvey George Kassiotis Sonia Gandhi Crick COVID-19 Consortium Charles Swanton Charlotte Fribbens Katalin Wilkinson Robert Wilkinson David K Lau Susana Banerjee Naureen Starling Ian Chau CAPTURE Consortium Samra Turajlic Toggle all authors (35)
Abstract
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.
Journal details
Journal Nature Medicine
Volume 27
Issue number 8
Pages 1362-1366
Available online
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Publisher website (DOI) 10.1038/s41591-021-01387-6
Europe PubMed Central 34040262
Pubmed 34040262
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