Cargando…

Immune-Related Pancytopenia Induced by Anti-PD-1 Therapy – Interrupt or Continue Treatment – The Role of Immunohistochemical Examination

Immune checkpoint inhibitors (ICIs), including anti-cytotoxic T-lymphocyte antigen 4 (anti-CTLA-4) and anti-programmed death receptor-1/ligand-1 (anti-PD-1/anti-PD-L1) caused a breakthrough in oncology and significantly improved therapeutic outcomes in cancer patients. ICIs generate a specific react...

Descripción completa

Detalles Bibliográficos
Autores principales: Cybulska-Stopa, Bożena, Gruchała, Andrzej, Niemiec, Maciej
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6873039/
https://www.ncbi.nlm.nih.gov/pubmed/31762755
http://dx.doi.org/10.1159/000504130
_version_ 1783472603521875968
author Cybulska-Stopa, Bożena
Gruchała, Andrzej
Niemiec, Maciej
author_facet Cybulska-Stopa, Bożena
Gruchała, Andrzej
Niemiec, Maciej
author_sort Cybulska-Stopa, Bożena
collection PubMed
description Immune checkpoint inhibitors (ICIs), including anti-cytotoxic T-lymphocyte antigen 4 (anti-CTLA-4) and anti-programmed death receptor-1/ligand-1 (anti-PD-1/anti-PD-L1) caused a breakthrough in oncology and significantly improved therapeutic outcomes in cancer patients. ICIs generate a specific reaction in T cells, directed against antigens on cancer cells, leading to their damage and death. Through similar or the same antigens, activated lymphocytes may also have a cytotoxic effect on healthy cells, causing development of specific adverse effects – so-called immune-related adverse events (irAEs). We present the case report of a 56 year old patient with disseminated melanoma. During treatment with immunotherapy (anti PD-1), neutropenic fever and pancytopenia occurred. Trepanobiopsy of the bone marrow was performed to determine the cause of pancytopenia. Histopathological assessment of bone marrow combined with immunophenotype investigations may explain the cause of hematological disorders occurring in the course of treatment with ICIs, and support the choice of an appropriate treatment, directly translated into positive outcomes.
format Online
Article
Text
id pubmed-6873039
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher S. Karger AG
record_format MEDLINE/PubMed
spelling pubmed-68730392019-11-22 Immune-Related Pancytopenia Induced by Anti-PD-1 Therapy – Interrupt or Continue Treatment – The Role of Immunohistochemical Examination Cybulska-Stopa, Bożena Gruchała, Andrzej Niemiec, Maciej Case Rep Oncol Case Report Immune checkpoint inhibitors (ICIs), including anti-cytotoxic T-lymphocyte antigen 4 (anti-CTLA-4) and anti-programmed death receptor-1/ligand-1 (anti-PD-1/anti-PD-L1) caused a breakthrough in oncology and significantly improved therapeutic outcomes in cancer patients. ICIs generate a specific reaction in T cells, directed against antigens on cancer cells, leading to their damage and death. Through similar or the same antigens, activated lymphocytes may also have a cytotoxic effect on healthy cells, causing development of specific adverse effects – so-called immune-related adverse events (irAEs). We present the case report of a 56 year old patient with disseminated melanoma. During treatment with immunotherapy (anti PD-1), neutropenic fever and pancytopenia occurred. Trepanobiopsy of the bone marrow was performed to determine the cause of pancytopenia. Histopathological assessment of bone marrow combined with immunophenotype investigations may explain the cause of hematological disorders occurring in the course of treatment with ICIs, and support the choice of an appropriate treatment, directly translated into positive outcomes. S. Karger AG 2019-10-29 /pmc/articles/PMC6873039/ /pubmed/31762755 http://dx.doi.org/10.1159/000504130 Text en Copyright © 2019 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/4.0/ This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Case Report
Cybulska-Stopa, Bożena
Gruchała, Andrzej
Niemiec, Maciej
Immune-Related Pancytopenia Induced by Anti-PD-1 Therapy – Interrupt or Continue Treatment – The Role of Immunohistochemical Examination
title Immune-Related Pancytopenia Induced by Anti-PD-1 Therapy – Interrupt or Continue Treatment – The Role of Immunohistochemical Examination
title_full Immune-Related Pancytopenia Induced by Anti-PD-1 Therapy – Interrupt or Continue Treatment – The Role of Immunohistochemical Examination
title_fullStr Immune-Related Pancytopenia Induced by Anti-PD-1 Therapy – Interrupt or Continue Treatment – The Role of Immunohistochemical Examination
title_full_unstemmed Immune-Related Pancytopenia Induced by Anti-PD-1 Therapy – Interrupt or Continue Treatment – The Role of Immunohistochemical Examination
title_short Immune-Related Pancytopenia Induced by Anti-PD-1 Therapy – Interrupt or Continue Treatment – The Role of Immunohistochemical Examination
title_sort immune-related pancytopenia induced by anti-pd-1 therapy – interrupt or continue treatment – the role of immunohistochemical examination
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6873039/
https://www.ncbi.nlm.nih.gov/pubmed/31762755
http://dx.doi.org/10.1159/000504130
work_keys_str_mv AT cybulskastopabozena immunerelatedpancytopeniainducedbyantipd1therapyinterruptorcontinuetreatmenttheroleofimmunohistochemicalexamination
AT gruchałaandrzej immunerelatedpancytopeniainducedbyantipd1therapyinterruptorcontinuetreatmenttheroleofimmunohistochemicalexamination
AT niemiecmaciej immunerelatedpancytopeniainducedbyantipd1therapyinterruptorcontinuetreatmenttheroleofimmunohistochemicalexamination