SARS‐CoV‐2‐induced remission of Hodgkin lymphoma

Abstract

SARS-CoV-2-induced remission of Hodgkin lymphoma A 61-year-old man was referred to the haematology department with progressive lymphadenopathy and weight loss. He was receiving haemodialysis for end-stage renal failure secondary to IgA nephropathy. He had been off immunosuppressive therapy for three years after a failed renal transplant. Needle-core biopsy of a supraclavicular node demonstrated Epstein-Barr virus (EBV)-positive classical Hodgkin lymphoma [EBV viral polymerase chain reaction (PCR) 4800 copies/ml; log 10 3Á68]. Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) revealed avid stage IIIs disease (left image, PET scan, and supplementary image PET/CT). Shortly after diagnosis he was admitted with breathlessness and wheeze and was diagnosed with PCR-positive SARS-CoV-2 pneumonia. After 11 days of best supportive ward-based care he was discharged to convalesce at home. No corticosteroid or immunochemotherapy was administered. Four months later, palpable lymphadenopathy had reduced and an interim PET/CT scan revealed widespread resolution of the lymphadenopathy and reduced metabolic uptake throughout (right image and supplementary image). The EBV viral PCR had also fallen to 413 copies/ml (log 10 2Á62). We hypothesise that the SARS-CoV-2 infection triggered an anti-tumour immune response, as has been described with other infections in the context of high-grade non-Hodgkin lymphoma. 1 The putative mechanisms of action include cross-reactivity of pathogen-specific T cells with tumour antigens and natural killer cell activation by inflammatory cytokines produced in response to infection.

Long non-coding RNAs in Epstein–Barr virus-related cancer

“…Parvez et al considered that further rigorous genetic and molecular studies would update treatment and preventive strategies for recently emerged variants [ 131 ]. Additionally, Challenor et al reported a case in which an EBV-positive Hodgkin lymphoma patient was diagnosed with COVID-19 4 months later, palpable lymphadenopathy was reduced, and a PET/CT scan showed widespread resolution of the lymphadenopathy and reduced metabolic uptake throughout [ 132 ]. Challenor et al hypothesized that COVID-19 infection triggered an anti-tumour immune response and assumed that the mechanisms for this included cross-reactivity of pathogen-specific T cells with tumour antigens and the activation of natural killer cells by inflammatory cytokines produced by infection [ 132 ].…”

Durable tracking anti-SARS-CoV-2 antibodies of cancer patients recovered from COVID-19

“…Thus, chemotherapy and radiotherapy should be safe treatments for the cancer patient recovered from COVID-19. Interestingly, there is also a report that anti-SARS-CoV-2 antibody triggered the anti-tumor immune response in a Hodgkin's lymphoma patient 13 . Therefore, the protective role of IgG antibodies against SARS-CoV-2 in the cancer patient is not only important for them to prevent virus infection, but maybe also bene cial for the cancer treatment.…”

Impact of COVID-19 in patients with lymphoid malignancies

“…Interestingly, there have also been a few reports of COVID-19 being beneficial to lymphoma patients, presumably due to an “immunostimulatory effect”. Challenor and Tucker[ 33 ] reported the case of a 61-year-old man who went into remission after SARS-CoV-2 infection without treatment. Sollini et al [ 34 ] also report a case of a patient with follicular lymphoma, who having achieved a partial remission after bendamustine-based therapy, went onto achieve a complete remission after asymptomatic COVID-19.…”