Thread by @VincentRK

Did COVID cause remission of an advanced cancer?

61 year old man was diagnosed with Hodgkin Lymphoma. He then developed COVID. Only got supportive care. No steroids or immunotherapy. 4 months later, cancer had mostly resolved (left image vs right) 🪢

onlinelibrary.wiley.com/doi/full/10.11…

There are 3 possible explanations:

1) Hodgkin Lymphoma is unique among cancers in that what you see as big lumps of tumor are not cancer cells: Bulk of tumor mass is just normal reactive lymphocytes with small amounts of cancer (Reed Sternberg) cells mixed in. (Owl like cells)

So after COVID the reactive cells may disappear due to the severe viral infection, making it look like the cancer has gone into remission. But maybe only the normal reactive cells have disappeared. Time will tell if the true Hodgkin cancer cells are still there and will come back

2) The second explanation is Hodgkin lymphoma is sometimes a difficult diagnosis and we always worry if the initial diagnosis was right. I'm sure the authors have checked this and excluded this possibility.

3) The third explanation is that it is possible that COVID truly triggered an antibody or T cell response that targeted the Hodgkins cancer cells and killed them.

This will be similar to (but in a good way)COVID targeting PF4 or platelets & causing clots or bleeding. Fascinating

This story has been published in a peer reviewed journal, and has been covered in news media. @Telegraph @PoliticsForAlI
#BJH #Covid #Cancer

https://twitter.com/politicsforali/status/1382443211407425543

Most cases of Hodgkin lymphoma are not associated with EBV. This patient had prior renal transplantation but was not on immunosuppressive treatments. The COVID triggered immune response may have also targeted EBV (specific or non specific) rather than Hodgkins directly.