Nivolumab-induced immune thrombocytopenia in a patient with malignant pleural mesothelioma
Malignant pleural mesothelioma (MPM) is a rare and highly aggressive tumor. Nivolumab showed durable antitumor effect in patients with recurrent MPM and was approved for those patients in Japan in 2018. Immune related adverse event (irAE) is occurred in various organs and is suggestive to be related...
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doaj-486b6d9f27f144cfbc1416d722fe105e2020-12-17T04:48:30ZengElsevierRespiratory Medicine Case Reports2213-00712020-01-0131101170Nivolumab-induced immune thrombocytopenia in a patient with malignant pleural mesotheliomaJun Sakakibara-Konishi0Mineyoshi Sato1Michiko Takimoto Sato2Kohei Kasahara3Masahiro Onozawa4Hidenori Mizugaki5Eiki Kikuchi6Hajime Asahina7Naofumi Shinagawa8Satoshi Konno9First Department of Medicine, Hokkaido University Hospital, Sapporo, Japan; Corresponding author. First Department of Medicine, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo, 060-8638, Japan.First Department of Medicine, Hokkaido University Hospital, Sapporo, JapanFirst Department of Medicine, Hokkaido University Hospital, Sapporo, JapanDepartment of Hematology, Hokkaido University Hospital, Sapporo, JapanDepartment of Hematology, Hokkaido University Hospital, Sapporo, JapanFirst Department of Medicine, Hokkaido University Hospital, Sapporo, JapanFirst Department of Medicine, Hokkaido University Hospital, Sapporo, JapanFirst Department of Medicine, Hokkaido University Hospital, Sapporo, JapanFirst Department of Medicine, Hokkaido University Hospital, Sapporo, JapanFirst Department of Medicine, Hokkaido University Hospital, Sapporo, JapanMalignant pleural mesothelioma (MPM) is a rare and highly aggressive tumor. Nivolumab showed durable antitumor effect in patients with recurrent MPM and was approved for those patients in Japan in 2018. Immune related adverse event (irAE) is occurred in various organs and is suggestive to be related to better outcome of nivolumab. Frequency of hematological irAE is low and there are few reports about hematological irAE and association between irAE and outcome of nivolumab in patients with MPM. We present a case of recurrent MPM who responded to nivolumab treatment and experienced nivolumab-induced immune thrombocytopenia (ITP). Although high dose dexamethasone was administered and platelet count increased transiently, re-administration of dexamethasone was required to maintain normal count of platelet. The careful and intensive management of ITP treatment is necessary in cases who show no response or relapse to initial glucocorticoids treatment. This is the first report about nivolumab-induced ITP and association with response to nivolumab in MPM.http://www.sciencedirect.com/science/article/pii/S221300712030383XMalignant pleural mesotheliomaNivolumabImmune thrombocytopenia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jun Sakakibara-Konishi Mineyoshi Sato Michiko Takimoto Sato Kohei Kasahara Masahiro Onozawa Hidenori Mizugaki Eiki Kikuchi Hajime Asahina Naofumi Shinagawa Satoshi Konno |
spellingShingle |
Jun Sakakibara-Konishi Mineyoshi Sato Michiko Takimoto Sato Kohei Kasahara Masahiro Onozawa Hidenori Mizugaki Eiki Kikuchi Hajime Asahina Naofumi Shinagawa Satoshi Konno Nivolumab-induced immune thrombocytopenia in a patient with malignant pleural mesothelioma Respiratory Medicine Case Reports Malignant pleural mesothelioma Nivolumab Immune thrombocytopenia |
author_facet |
Jun Sakakibara-Konishi Mineyoshi Sato Michiko Takimoto Sato Kohei Kasahara Masahiro Onozawa Hidenori Mizugaki Eiki Kikuchi Hajime Asahina Naofumi Shinagawa Satoshi Konno |
author_sort |
Jun Sakakibara-Konishi |
title |
Nivolumab-induced immune thrombocytopenia in a patient with malignant pleural mesothelioma |
title_short |
Nivolumab-induced immune thrombocytopenia in a patient with malignant pleural mesothelioma |
title_full |
Nivolumab-induced immune thrombocytopenia in a patient with malignant pleural mesothelioma |
title_fullStr |
Nivolumab-induced immune thrombocytopenia in a patient with malignant pleural mesothelioma |
title_full_unstemmed |
Nivolumab-induced immune thrombocytopenia in a patient with malignant pleural mesothelioma |
title_sort |
nivolumab-induced immune thrombocytopenia in a patient with malignant pleural mesothelioma |
publisher |
Elsevier |
series |
Respiratory Medicine Case Reports |
issn |
2213-0071 |
publishDate |
2020-01-01 |
description |
Malignant pleural mesothelioma (MPM) is a rare and highly aggressive tumor. Nivolumab showed durable antitumor effect in patients with recurrent MPM and was approved for those patients in Japan in 2018. Immune related adverse event (irAE) is occurred in various organs and is suggestive to be related to better outcome of nivolumab. Frequency of hematological irAE is low and there are few reports about hematological irAE and association between irAE and outcome of nivolumab in patients with MPM. We present a case of recurrent MPM who responded to nivolumab treatment and experienced nivolumab-induced immune thrombocytopenia (ITP). Although high dose dexamethasone was administered and platelet count increased transiently, re-administration of dexamethasone was required to maintain normal count of platelet. The careful and intensive management of ITP treatment is necessary in cases who show no response or relapse to initial glucocorticoids treatment. This is the first report about nivolumab-induced ITP and association with response to nivolumab in MPM. |
topic |
Malignant pleural mesothelioma Nivolumab Immune thrombocytopenia |
url |
http://www.sciencedirect.com/science/article/pii/S221300712030383X |
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