Multiple drugs: COVID-19 pneumonia, cytokine release syndrome, off label use and lack of efficacy: case report.

A 21-year-old man with chronic myeloid leukemia developed COVID-19 pneumonia and cytokine release syndrome (CRS) while receiving immunosuppressive treatment for graft versus host disease (GvHD) prophylaxis. Despite off-label treatment with various medications, including azithromycin, hydroxychloroquine, hydrocortisone, and tocilizumab, the patient did not respond well. He eventually developed macrophage activation syndrome and CRS, but was successfully treated with dexamethasone, immune globulin, and ruxolitinib. The use of immunosuppressive therapy with cyclophosphamide, ciclosporin, and mycophenolate mofetil was believed to have contributed to the development of COVID-19 pneumonia and CRS. [Extracted from the article]