Case Discussion and Literature Review: Cancer Immunotherapy, Severe Immune-Related Adverse Events, Multi-Inflammatory Syndrome, and Severe Acute Respiratory Syndrome Coronavirus 2

Dristhi Ragoonanan; Sajad J Khazal; Rodrigo Mejia; Linette Ewing; Jean-Bernard Durand; Lara Bashoura; Jean Tayar; Natalie Dailey Garnes; Demetrios Petropoulos; Priti Tewari; Micah Bhatti; Ali Haider Ahmad; Jose Cortes; Shehla Razvi; Katrina McBeth; Rita Swinford; Basirat Shoberu; Waseem Waseemuddin; Linda Chi; Jonathan B Gill; Wafik Zaky; Najat Daw; Cristina Gutierrez; Welela Tereffe; Partow Kebriaei; Katayoun Rezvani; Elizabeth J Shpall; Richard E Champlin; Kris M Mahadeo

doi:10.3389/fonc.2021.625707

Case Discussion and Literature Review: Cancer Immunotherapy, Severe Immune-Related Adverse Events, Multi-Inflammatory Syndrome, and Severe Acute Respiratory Syndrome Coronavirus 2

Front Oncol. 2021 Feb 4:11:625707. doi: 10.3389/fonc.2021.625707. eCollection 2021.

Authors

Dristhi Ragoonanan¹, Sajad J Khazal¹, Rodrigo Mejia², Linette Ewing², Jean-Bernard Durand³, Lara Bashoura⁴, Jean Tayar⁵, Natalie Dailey Garnes⁶, Demetrios Petropoulos¹, Priti Tewari¹, Micah Bhatti⁷, Ali Haider Ahmad², Jose Cortes², Shehla Razvi², Katrina McBeth⁸, Rita Swinford⁹, Basirat Shoberu¹, Waseem Waseemuddin¹, Linda Chi¹⁰, Jonathan B Gill¹¹, Wafik Zaky¹¹, Najat Daw¹¹, Cristina Gutierrez¹², Welela Tereffe¹³, Partow Kebriaei¹⁴, Katayoun Rezvani¹⁴, Elizabeth J Shpall¹⁴, Richard E Champlin¹⁴, Kris M Mahadeo¹

Affiliations

¹ Pediatric Stem Cell Transplantation and Cellular Therapy, CARTOX Program, University of Texas at MD Anderson Cancer Center, Houston, TX, United States.
² Pediatric Critical Care Medicine, University of Texas at MD Anderson Cancer Center, Houston, TX, United States.
³ Department of Cardiology, University of Texas at MD Anderson Cancer Center, Houston, TX, United States.
⁴ Department of Pulmonary Medicine, University of Texas at MD Anderson Cancer Center, Houston, TX, United States.
⁵ Department of Rheumatology, University of Texas at MD Anderson Cancer Center, Houston, TX, United States.
⁶ Department of Infectious Disease, University of Texas at MD Anderson Cancer Center, Houston, TX, United States.
⁷ Department of Pathology, University of Texas at MD Anderson Cancer Center, Houston, TX, United States.
⁸ Department of Pediatric Pulmonary Medicine, University of Texas at MD Anderson Cancer Center, Houston, TX, United States.
⁹ Department of Pediatric Nephrology, University of Texas at MD Anderson Cancer Center, Houston, TX, United States.
¹⁰ Department of Neuroradiology, CARTOX Program, University of Texas at MD Anderson Cancer Center, Houston, TX, United States.
¹¹ Department of Pediatric Oncology, University of Texas at MD Anderson Cancer Center, Houston, TX, United States.
¹² Department of Critical Care Medicine, CARTOX Program, University of Texas at MD Anderson Cancer Center, Houston, TX, United States.
¹³ University of Texas at MD Anderson Cancer Center, Houston, TX, United States.
¹⁴ Stem Cell Transplantation and Cellular Therapy, CARTOX Program, University of Texas at MD Anderson Cancer Center, Houston, TX, United States.

Abstract

Pediatric, adolescent and young adult (AYA) patients receiving novel cancer immunotherapies may develop associated toxicities with overlapping signs and symptoms that are not always easily distinguished from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection/clinical sequelae. We describe 2 diagnostically challenging cases of SARS-CoV-2 and Multi-Inflammatory Syndrome-Adult (MIS-A), in patients with a history of acute lymphoblastic leukemia following cellular therapy administration and review evolving characterization of both the natural course of SARS-CoV-2 infection and toxicities experienced in younger cancer immunotherapy patients. Vigilant monitoring for unique presentations and epidemiologic surveillance to promptly detect changes in incidence of either condition may be warranted.

Keywords: COVID-19; MIS-A; MIS-C; SARS-CoV-2; cancer immunotherapy.

Copyright © 2021 Ragoonanan, Khazal, Mejia, Ewing, Durand, Bashoura, Tayar, Dailey Garnes, Petropoulos, Tewari, Bhatti, Ahmad, Cortes, Razvi, McBeth, Swinford, Shoberu, Waseemuddin, Chi, Gill, Zaky, Daw, Gutierrez, Tereffe, Kebriaei, Rezvani, Shpall, Champlin and Mahadeo.

Publication types

Review