Diagnosis and Management of Hematological Adverse Events Induced by Immune Checkpoint Inhibitors: A Systematic Review
There has been less volume of literature focusing on the Immune-related Hematological Adverse Drug Events (Hem-irAEs) of Immune Checkpoint Inhibitors (ICPis) in cancer patients. Furthermore, there has been no consensus about the management of hematological toxicity from immunotherapy in the recently...
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doaj-21d0ac4b96434941a6d7b32e75fff5412020-11-25T04:05:28ZengFrontiers Media S.A.Frontiers in Immunology1664-32242020-10-011110.3389/fimmu.2020.01354531929Diagnosis and Management of Hematological Adverse Events Induced by Immune Checkpoint Inhibitors: A Systematic ReviewNabil E. Omar0Kareem A. El-Fass1Abdelrahman I. Abushouk2Noha Elbaghdady3Abd Elmonem M. Barakat4Ahmed E. Noreldin5Dina Johar6Mohamed Yassin7Anas Hamad8Shereen Elazzazy9Said Dermime10Pharmacy Department, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, QatarDepartment of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Hofuf, Saudi ArabiaDivision of Cardiology, Department of Medicine, Harvard Medical School, Boston, MA, United StatesClinical Pharmacy Department, School of Pharmacy, New Giza University, Giza, EgyptFaculty of Veterinary Medicine, Damanhour University, Damanhour, EgyptDepartment of Histology and Cytology, Faculty of Veterinary Medicine, Damanhour University, Damanhour, EgyptBasic Sciences Department, Faculty of Medicine, Algalala University, Suez, EgyptMedical Oncology-Hematology Section, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, QatarPharmacy Department, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, QatarPharmacy Department, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, QatarNational Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, QatarThere has been less volume of literature focusing on the Immune-related Hematological Adverse Drug Events (Hem-irAEs) of Immune Checkpoint Inhibitors (ICPis) in cancer patients. Furthermore, there has been no consensus about the management of hematological toxicity from immunotherapy in the recently published practice guidelines by the European Society for Medical Oncology (ESMO). We conducted a systematic review of case reports/series to describe the diagnosis and management of potentially rare and unrecognized Hem-irAEs. We searched Medline, OVID, Web of Science for eligible articles. Data were extracted on patient characteristics, Hem-irAEs, and management strategies. We performed quality assessment using the Pierson-5 evaluation scheme and causality assessment using the Naranjo scale. Our search retrieved 49 articles that described 118 cases. The majority of patients had melanoma (57.6%) and lung cancer (26.3%). The most common Hem-irAEs reported with ICPis (such as nivolumab, ipilimumab, and pembrolizumab) were thrombocytopenia, hemolytic and aplastic anemias. Less reported adverse events included agranulocytosis and neutropenia. Steroids were commonly used to treat these adverse events with frequent success. Other used strategies included intravenous immunoglobulins (IVIG), rituximab, and transfusion of blood components. The findings of this review provide more insights into the diagnosis and management of the rarely reported Hem-irAEs of ICPis.https://www.frontiersin.org/articles/10.3389/fimmu.2020.01354/fullimmune checkpoint inhibitorsimmune-related adverse eventsipilimumabpembrolizumabnivolumabatezolizumab |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nabil E. Omar Kareem A. El-Fass Abdelrahman I. Abushouk Noha Elbaghdady Abd Elmonem M. Barakat Ahmed E. Noreldin Dina Johar Mohamed Yassin Anas Hamad Shereen Elazzazy Said Dermime |
spellingShingle |
Nabil E. Omar Kareem A. El-Fass Abdelrahman I. Abushouk Noha Elbaghdady Abd Elmonem M. Barakat Ahmed E. Noreldin Dina Johar Mohamed Yassin Anas Hamad Shereen Elazzazy Said Dermime Diagnosis and Management of Hematological Adverse Events Induced by Immune Checkpoint Inhibitors: A Systematic Review Frontiers in Immunology immune checkpoint inhibitors immune-related adverse events ipilimumab pembrolizumab nivolumab atezolizumab |
author_facet |
Nabil E. Omar Kareem A. El-Fass Abdelrahman I. Abushouk Noha Elbaghdady Abd Elmonem M. Barakat Ahmed E. Noreldin Dina Johar Mohamed Yassin Anas Hamad Shereen Elazzazy Said Dermime |
author_sort |
Nabil E. Omar |
title |
Diagnosis and Management of Hematological Adverse Events Induced by Immune Checkpoint Inhibitors: A Systematic Review |
title_short |
Diagnosis and Management of Hematological Adverse Events Induced by Immune Checkpoint Inhibitors: A Systematic Review |
title_full |
Diagnosis and Management of Hematological Adverse Events Induced by Immune Checkpoint Inhibitors: A Systematic Review |
title_fullStr |
Diagnosis and Management of Hematological Adverse Events Induced by Immune Checkpoint Inhibitors: A Systematic Review |
title_full_unstemmed |
Diagnosis and Management of Hematological Adverse Events Induced by Immune Checkpoint Inhibitors: A Systematic Review |
title_sort |
diagnosis and management of hematological adverse events induced by immune checkpoint inhibitors: a systematic review |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Immunology |
issn |
1664-3224 |
publishDate |
2020-10-01 |
description |
There has been less volume of literature focusing on the Immune-related Hematological Adverse Drug Events (Hem-irAEs) of Immune Checkpoint Inhibitors (ICPis) in cancer patients. Furthermore, there has been no consensus about the management of hematological toxicity from immunotherapy in the recently published practice guidelines by the European Society for Medical Oncology (ESMO). We conducted a systematic review of case reports/series to describe the diagnosis and management of potentially rare and unrecognized Hem-irAEs. We searched Medline, OVID, Web of Science for eligible articles. Data were extracted on patient characteristics, Hem-irAEs, and management strategies. We performed quality assessment using the Pierson-5 evaluation scheme and causality assessment using the Naranjo scale. Our search retrieved 49 articles that described 118 cases. The majority of patients had melanoma (57.6%) and lung cancer (26.3%). The most common Hem-irAEs reported with ICPis (such as nivolumab, ipilimumab, and pembrolizumab) were thrombocytopenia, hemolytic and aplastic anemias. Less reported adverse events included agranulocytosis and neutropenia. Steroids were commonly used to treat these adverse events with frequent success. Other used strategies included intravenous immunoglobulins (IVIG), rituximab, and transfusion of blood components. The findings of this review provide more insights into the diagnosis and management of the rarely reported Hem-irAEs of ICPis. |
topic |
immune checkpoint inhibitors immune-related adverse events ipilimumab pembrolizumab nivolumab atezolizumab |
url |
https://www.frontiersin.org/articles/10.3389/fimmu.2020.01354/full |
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