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[18F]FDG PET/CT in patients affected by SARS-CoV-2 and lymphoproliferative disorders and treated with tocilizumab

Title: [18F]FDG PET/CT in patients affected by SARS-CoV-2 and lymphoproliferative disorders and treated with tocilizumab
Authors: Signore, Alberto; Lauri, Chiara; Bianchi, Maria Paola; Pelliccia, Sabrina; Lenza, Andrea; Tetti, Simone; Martini, Maria Luisa; Franchi, Gabriele; Trapasso, Fabio; De Biase, Luciano; Aceti, Antonio; Tafuri, Agostino
Contributors: Signore, Alberto; Lauri, Chiara; Bianchi, Maria Paola; Pelliccia, Sabrina; Lenza, Andrea; Tetti, Simone; Martini, Maria Luisa; Franchi, Gabriele; Trapasso, Fabio; De Biase, Luciano; Aceti, Antonio; Tafuri, Agostino
Publication Year: 2022
Collection: Sapienza Università di Roma: CINECA IRIS
Subject Terms: Covid-19; SARS-CoV-2; [18F]FDG PET/CT; pneumonia; tocilizumab
Description: Objectives: Interstitial pneumonia is a severe complication induced by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Several treatments have been proposed alone or, more often, in combination, depending, also, on the presence of other organ disfunction. The most frequently related, well-described, and associated phenomenon is pan-lymphopenia with circulating, high levels of cytokines. We report, here, on two patients with COVID-19 and lymphoproliferative disorders treated with Tocilizumab (a humanized monoclonal antibody against the interleukin-6 receptor) and followed by an [18F]FDG PET/CT to early evaluate the therapy's efficacy. Methods: One patient with angioimmunoblastic T-lymphoma (A), one with Hodgkin lymphoma (A), and both with positive RT-PCR for SARS-CoV-2 and with similar clinical findings of interstitial pneumonia at the CT scan, were imaged by [18F]FDG PET/CT before and 14 days after a single dose of Tocilizumab. Results: In both patients, the basal [18F]FDG PET/CT showed a diffused lung parenchyma uptake, corresponding to the hyperdense areas at the CT scan. After 2 weeks of a Tocilizumab infusion, patient B had an improvement of symptoms, with normalization of the [18F]FDG uptake. By contrast, patient A, who was still symptomatic, showed a persisting and abnormal distribution of [18F]FDG. Interestingly, both patients showed a low bone marrow uptake of [18F]FDG at the diagnosis and after 15 days, while the spleen uptake was low only in lymphopenic patient A; both are indirect signs of an immune deficiency. Conclusions: In conclusion, in these two patients, interstitial pneumonia was efficiently treated with Tocilizumab, as demonstrated by the [18F]FDG PET/CT. Our results confirm that interleukin-6 (IL6) has a role in the COVID-19 disease and that anti-cytokine treatment can also be performed in patients with lymphoproliferative disorders.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/36579547; info:eu-repo/semantics/altIdentifier/wos/WOS:000881361400001; volume:12; issue:11; firstpage:1; lastpage:7; numberofpages:7; journal:JOURNAL OF PERSONALIZED MEDICINE; https://hdl.handle.net/11573/1695999
DOI: 10.3390/jpm12111839
Availability: https://hdl.handle.net/11573/1695999; https://doi.org/10.3390/jpm12111839
Rights: info:eu-repo/semantics/openAccess
Accession Number: edsbas.89D48A1C
Database: BASE