Pastor Danielle M, Lee-Wisdom Katherine, Arai Andrew E, Sirajuddin Arlene, Rosing Douglas R, Korchin Borys, Gulley James L, Bilusic Marijo
Medical Oncology Service, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States.
Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States.
Front Oncol. 2020 Nov 16;10:603248. doi: 10.3389/fonc.2020.603248. eCollection 2020.
The emergence of the SARS-CoV-2 virus has been associated with perplexing clinical sequelae and phenomena that often have no clear link to the underlying infection. There is a wide spectrum of symptoms associated with infection, from minimal respiratory complaints to severe multi-organ failure, often resulting in death. Individuals with malignancies, particularly those whose treatments have left them immunocompromised or immunosuppressed, are among the patient populations thought to be at greater risk for more severe illness. A man with aggressive metastatic chordoma contracted the SARS-CoV-2 virus and was diagnosed with COVID-19 while undergoing intravenous brachyury vaccine immunotherapy. His disease course was remarkably mild, and the virus cleared rapidly. Despite a treatment delay of 3 months due to the COVID-19 pandemic, the patient's disease has been stable and tumor-related pain has significantly improved. This suggests not only an intact, functional immune system, but also one that appears to have been responsive to cancer treatment. It has been suggested that individuals undergoing treatment for metastatic cancer are at greater risk of severe SARS-CoV-2-related illnesses and complications. While immunosuppression may be a problem, particularly in those receiving conventional chemotherapeutic agents, it is possible that the non-specific effects of immune-enhancing therapies may confer some protection against SARS-CoV-2.
严重急性呼吸综合征冠状病毒2(SARS-CoV-2)病毒的出现与令人困惑的临床后遗症和现象有关,这些后遗症和现象往往与潜在感染没有明确联系。感染相关的症状范围很广,从轻微的呼吸道不适到严重的多器官功能衰竭,常常导致死亡。患有恶性肿瘤的个体,尤其是那些治疗后导致免疫功能低下或免疫抑制的个体,被认为是患更严重疾病风险更高的患者群体。一名患有侵袭性转移性脊索瘤的男子在接受静脉注射短尾病毒疫苗免疫治疗时感染了SARS-CoV-2病毒,并被诊断为新冠肺炎。他的病程非常轻微,病毒迅速清除。尽管由于新冠肺炎疫情治疗延迟了3个月,但患者的病情一直稳定,与肿瘤相关的疼痛也有显著改善。这不仅表明免疫系统完整且功能正常,而且似乎对癌症治疗有反应。有人提出,正在接受转移性癌症治疗的个体患与SARS-CoV-2相关的严重疾病和并发症的风险更高。虽然免疫抑制可能是一个问题,特别是在那些接受传统化疗药物治疗的个体中,但免疫增强疗法的非特异性作用可能会对SARS-CoV-2提供一些保护。