Severe acute myositis and myocarditis on initiation of 6-weekly pembrolizumab post-COVID-19 mRNA vaccination
oleh: Brian Shine, Robert Pell, Weiyu Ye, Mark R Middleton, Tim James, Stephanie Jones, Robert A Watson, Ian S D Roberts, Monika Hofer, Damian Jenkins, Miranda J Payne, Nicholas Coupe, Chelsea A Taylor, Elsita Jungkurth, Rosalin Cooper, Orion Tong, Eleni Ieremia, David Maldonado-Perez, Benjamin P Fairfax
| Format: | Article |
|---|---|
| Diterbitkan: | BMJ Publishing Group 2024-04-01 |
Deskripsi
We describe three cases of critical acute myositis with myocarditis occurring within 22 days of each other at a single institution, all within 1 month of receiving the initial cycle of the anti-PD-1 drug pembrolizumab. Analysis of T cell receptor repertoires from peripheral blood and tissues revealed a high degree of clonal expansion and public clones between cases, with several T cell clones expanded within the skeletal muscle putatively recognizing viral epitopes. All patients had recently received a COVID-19 mRNA booster vaccine prior to treatment and were positive for SARS-CoV2 Spike antibody. In conclusion, we report a series of unusually severe myositis and myocarditis following PD-1 blockade and the COVID-19 mRNA vaccination.