Cytokine release syndrome in a patient with colorectal cancer after vaccination with BNT162b2

Nat Med. 2021 Aug;27(8):1362-1366. doi: 10.1038/s41591-021-01387-6. Epub 2021 May 26.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19 / metabolism
  • COVID-19 / prevention & control
  • COVID-19 Vaccines / adverse effects*
  • Colorectal Neoplasms / metabolism*
  • Cytokine Release Syndrome*
  • Humans
  • Male
  • SARS-CoV-2 / isolation & purification

Substances

  • COVID-19 Vaccines