No need to hesitate: immune‐related neutropenia and thrombocytopenia that improved by corticosteroids
Abstract Unlike cytotoxicity, haematological toxicity is a rare immune‐related adverse event that is occasionally irreversible and refractory. A 67‐year‐old man was diagnosed with advanced lung squamous cell carcinoma. After 41 cycles of nivolumab as third‐line chemotherapy, the patient developed se...
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Online Access: | https://doi.org/10.1002/rcr2.799 |
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doaj-e1cd68c603ab415f81700512450000c92021-06-24T04:04:32ZengWileyRespirology Case Reports2051-33802021-07-0197n/an/a10.1002/rcr2.799No need to hesitate: immune‐related neutropenia and thrombocytopenia that improved by corticosteroidsOsamu Kanai0Koichi Nakatani1Kohei Fujita2Misato Okamura3Tadashi Mio4Division of Respiratory Medicine National Hospital Organization Kyoto Medical Center Kyoto JapanDivision of Respiratory Medicine National Hospital Organization Kyoto Medical Center Kyoto JapanDivision of Respiratory Medicine National Hospital Organization Kyoto Medical Center Kyoto JapanDivision of Respiratory Medicine National Hospital Organization Kyoto Medical Center Kyoto JapanDivision of Respiratory Medicine National Hospital Organization Kyoto Medical Center Kyoto JapanAbstract Unlike cytotoxicity, haematological toxicity is a rare immune‐related adverse event that is occasionally irreversible and refractory. A 67‐year‐old man was diagnosed with advanced lung squamous cell carcinoma. After 41 cycles of nivolumab as third‐line chemotherapy, the patient developed severe neutropenia and thrombocytopenia. The bone marrow biopsy and serum immunological tests indicated no evidence of bone marrow failure and suggested autoimmune mature blood cell destruction. After initiating treatment with prednisolone 50 mg orally and filgrastim 75 μg subcutaneously once daily, neutropenia and thrombocytopenia recovered within four and nine days, respectively. The filgrastim was discontinued four days later, and the corticosteroid was discontinued three months later; there has been no haemocytopenia recurrence since then. The patient has remained untreated for more than two years without progression of lung cancer. In conclusion, corticosteroids should be considered for the treatment of autoimmune haemocytopenia if refractory bone marrow dysplasia can be ruled out.https://doi.org/10.1002/rcr2.799Chemotherapyimmune checkpoint inhibitorimmunotherapylung cancernon‐small cell lung cancer |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Osamu Kanai Koichi Nakatani Kohei Fujita Misato Okamura Tadashi Mio |
spellingShingle |
Osamu Kanai Koichi Nakatani Kohei Fujita Misato Okamura Tadashi Mio No need to hesitate: immune‐related neutropenia and thrombocytopenia that improved by corticosteroids Respirology Case Reports Chemotherapy immune checkpoint inhibitor immunotherapy lung cancer non‐small cell lung cancer |
author_facet |
Osamu Kanai Koichi Nakatani Kohei Fujita Misato Okamura Tadashi Mio |
author_sort |
Osamu Kanai |
title |
No need to hesitate: immune‐related neutropenia and thrombocytopenia that improved by corticosteroids |
title_short |
No need to hesitate: immune‐related neutropenia and thrombocytopenia that improved by corticosteroids |
title_full |
No need to hesitate: immune‐related neutropenia and thrombocytopenia that improved by corticosteroids |
title_fullStr |
No need to hesitate: immune‐related neutropenia and thrombocytopenia that improved by corticosteroids |
title_full_unstemmed |
No need to hesitate: immune‐related neutropenia and thrombocytopenia that improved by corticosteroids |
title_sort |
no need to hesitate: immune‐related neutropenia and thrombocytopenia that improved by corticosteroids |
publisher |
Wiley |
series |
Respirology Case Reports |
issn |
2051-3380 |
publishDate |
2021-07-01 |
description |
Abstract Unlike cytotoxicity, haematological toxicity is a rare immune‐related adverse event that is occasionally irreversible and refractory. A 67‐year‐old man was diagnosed with advanced lung squamous cell carcinoma. After 41 cycles of nivolumab as third‐line chemotherapy, the patient developed severe neutropenia and thrombocytopenia. The bone marrow biopsy and serum immunological tests indicated no evidence of bone marrow failure and suggested autoimmune mature blood cell destruction. After initiating treatment with prednisolone 50 mg orally and filgrastim 75 μg subcutaneously once daily, neutropenia and thrombocytopenia recovered within four and nine days, respectively. The filgrastim was discontinued four days later, and the corticosteroid was discontinued three months later; there has been no haemocytopenia recurrence since then. The patient has remained untreated for more than two years without progression of lung cancer. In conclusion, corticosteroids should be considered for the treatment of autoimmune haemocytopenia if refractory bone marrow dysplasia can be ruled out. |
topic |
Chemotherapy immune checkpoint inhibitor immunotherapy lung cancer non‐small cell lung cancer |
url |
https://doi.org/10.1002/rcr2.799 |
work_keys_str_mv |
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1721361863069925376 |