彭布罗利珠单抗
医学
中性粒细胞减少症
中止
不利影响
内科学
免疫学
免疫系统
肝炎
白细胞减少症
作者
Soichiro Nakako,Yasuhiro Nakashima,Hiroshi Okamura,Yoko Tani,Takahiro Ueda,Yosuke Makuuchi,Masatomo Kuno,Teruhito Takakuwa,Mitsutaka Nishimoto,Hideo Koh,Hirohisa Nakamae,Masayuki Hino
出处
期刊:Immunotherapy
[Future Medicine]
日期:2022-02-01
卷期号:14 (2): 101-105
被引量:5
标识
DOI:10.2217/imt-2021-0131
摘要
Case presentation: A 72-year-old man with non-small-cell lung cancer received four cycles of pembrolizumab-containing chemotherapy. He developed multiple immune-related adverse events (irAEs) and discontinued immune checkpoint inhibitors (ICIs); however, he developed immune-related hepatitis and grade 4 neutropenia at 92 days and 118 days, respectively, from discontinuation. He received G-CSF and methylprednisolone pulse therapy and recovered from neutropenia 12 days later. Discussion & conclusion: ICI-induced neutropenia is a life-threatening condition. The longest recorded onset in one study cohort is 26 days after the final administration of ICIs. This case developed strikingly delayed immune-related neutropenia manifesting as a delayed irAE. Clinicians should pay close attention to delayed immune-related neutropenia as a possible life-threatening irAE after ICI treatment.Lay abstract This case report describes a 72-year-old man with non-small-cell lung cancer who received four cycles of pembrolizumab-containing chemotherapy. He developed multiple immune-related adverse events (irAEs), which are significant side effects of immune checkpoint inhibitors (ICIs). Despite the discontinuation of pembrolizumab due to multiple irAEs, he developed immune-related hepatitis and neutropenia at 92 days and 118 days, respectively, after the final pembrolizumab dose. He received supportive care and immunosuppressive therapy and recovered from neutropenia. Recently, delayed development of irAEs was reported even in patients that discontinued ICIs; this is referred to as a delayed immune-related event (DIRE). This case developed strikingly delayed immune-related neutropenia as a DIRE. Clinicians should pay close attention to neutropenia as a possible life-threatening DIRE after ICI treatment.
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