key: cord-0700304-potbfnor
authors: Sgherza, Nicola; Curci, Paola; Strafella, Vanda; Rizzi, Rita; Musto, Pellegrino
title: Implications of Interleukin-6 (IL-6)-blockade for severe COVID-19 infection in patients with Multiple Myeloma
date: 2021-05-12
journal: Acta Biomed
DOI: 10.23750/abm.v92i2.11395
sha: 7a44600264b3a625f8de4960119ad65eb6adddb2
doc_id: 700304
cord_uid: potbfnor

nan

The most used IL-6 inhibitor was tocilizumab, FDA approved for the management of CAR T-cell related Cytokine Release Syndrome (CRS) while no patient was reported treated with siltuximab. Clinical outcome (alive/deceased) is available for 40 on 49 patients with questionable results: 20 patients (50%) died, 20 patients (50%) survived. Certainly, although this retrospective review includes a quite large cohort of patients (556), providing interesting information, several limitations to generalizability of findings are present. First, the number of patients with MM and COVID-19 infection treated with IL-6 inhibitors in the world, is certainly higher than one reported in case reports/case series. Second, data represent experiences of patients from different centers, treated differently in terms of drugs and according to their availability at different hospitals. Third, patients received also additional therapies for COVID-19 including hydroxychloroquine and anti-viral agents, so it is no possible distinguish absolutely the efficacy of tocilizumab (or other IL-6 inhibitors) from other drugs. An interesting aspect to focus on is the potential use of tocilizumab against MM. IL-6 is the major growth factor of human myeloma cells through an autocrine or a paracrine mechanism and tocilizumab was reported to inhibit their proliferation in vitro (5) and to be effective in stabilize serum monoclonal protein in patients with systemic diseases (i.e. rheumatological disorders) and concomitant MM (6) . So, in the subset of active MM patients with severe COVID-19 infection, in whom other anti-myeloma treatments could be not administrable, the possibility that tocilizumab could represent a treatment option with a double action ( Figure 1 ) against cytokine storm due to COVID-19 and MM itself would warrant to be verified.

Each author declares that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article.

Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China

Potential Role of Anti-interleukin (IL)-6 Drugs in the Treatment of COVID-19: Rationale, Clinical Evidence and Risks

IL-6 Inhibitors in the Treatment of Serious COVID-19: A Promising Therapy

Rational Use of Tocilizumab in the Treatment of Novel Coronavirus Pneumonia

not available Table 1. Summary of studies of IL-6 inhibitors for COVID-19 infection in patients with multiple myeloma

Humanized antiinterleukin-6 receptor monoclonal antibody induced apoptosis of fresh and cloned human myeloma cells in vitro

Correspondence: Nicola Sgherza, MD, PhD Hematology and Bone Marrow Transplantation Unit -AOUC Policlinico, Department of Emergency and Organ Transplantation