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Case Report: Lymphocytosis Associated With Fatal Hepatitis in a Thymoma Patient Treated With Anti-PD1: New Insight Into the Immune-Related Storm

Recent advances in tumor immunotherapy have made it possible to efficiently unleash immune effectors, reacting against neoplastic cells. Although these approaches primarily aim to eradicate malignancy, immune-related adverse events (irAEs) often influence patients’ prognosis, constituting a new spec...

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Autores principales: Argentiero, Antonella, Solimando, Antonio Giovanni, Ungaro, Valentina, Laforgia, Mariarita, Strippoli, Sabino, Pinto, Dario, Negri, Antonio, Ferraiuolo, Simona, Zito, Alfredo, Guida, Michele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768075/
https://www.ncbi.nlm.nih.gov/pubmed/33381454
http://dx.doi.org/10.3389/fonc.2020.583781
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author Argentiero, Antonella
Solimando, Antonio Giovanni
Ungaro, Valentina
Laforgia, Mariarita
Strippoli, Sabino
Pinto, Dario
Negri, Antonio
Ferraiuolo, Simona
Zito, Alfredo
Guida, Michele
author_facet Argentiero, Antonella
Solimando, Antonio Giovanni
Ungaro, Valentina
Laforgia, Mariarita
Strippoli, Sabino
Pinto, Dario
Negri, Antonio
Ferraiuolo, Simona
Zito, Alfredo
Guida, Michele
author_sort Argentiero, Antonella
collection PubMed
description Recent advances in tumor immunotherapy have made it possible to efficiently unleash immune effectors, reacting against neoplastic cells. Although these approaches primarily aim to eradicate malignancy, immune-related adverse events (irAEs) often influence patients’ prognosis, constituting a new spectrum of side effects. Taking into account the typical microenvironment and the intricate equilibrium between the anti-tumor response and the immune cells, the thymoma constitutes a unicum in the immune-oncology field. We report a fatal immune-mediated adverse events’ storm in a thymoma patient treated with Pembrolizumab, leading to hepatotoxicity accompanied by lymphocytosis, thrombocytopenia, and thyroid dysfunction, unveiling a novel potential pathophysiological effect of immunotherapy. The clinical proficiency of the immune checkpoint inhibitors in thymoma patients warrants timely prevention and management of off-target consequences in order to optimize this promising therapeutic option. This case report describes a unique consequence of irAEs, emerging as a red flag warranting a multidisciplinary approach.
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spelling pubmed-77680752020-12-29 Case Report: Lymphocytosis Associated With Fatal Hepatitis in a Thymoma Patient Treated With Anti-PD1: New Insight Into the Immune-Related Storm Argentiero, Antonella Solimando, Antonio Giovanni Ungaro, Valentina Laforgia, Mariarita Strippoli, Sabino Pinto, Dario Negri, Antonio Ferraiuolo, Simona Zito, Alfredo Guida, Michele Front Oncol Oncology Recent advances in tumor immunotherapy have made it possible to efficiently unleash immune effectors, reacting against neoplastic cells. Although these approaches primarily aim to eradicate malignancy, immune-related adverse events (irAEs) often influence patients’ prognosis, constituting a new spectrum of side effects. Taking into account the typical microenvironment and the intricate equilibrium between the anti-tumor response and the immune cells, the thymoma constitutes a unicum in the immune-oncology field. We report a fatal immune-mediated adverse events’ storm in a thymoma patient treated with Pembrolizumab, leading to hepatotoxicity accompanied by lymphocytosis, thrombocytopenia, and thyroid dysfunction, unveiling a novel potential pathophysiological effect of immunotherapy. The clinical proficiency of the immune checkpoint inhibitors in thymoma patients warrants timely prevention and management of off-target consequences in order to optimize this promising therapeutic option. This case report describes a unique consequence of irAEs, emerging as a red flag warranting a multidisciplinary approach. Frontiers Media S.A. 2020-12-14 /pmc/articles/PMC7768075/ /pubmed/33381454 http://dx.doi.org/10.3389/fonc.2020.583781 Text en Copyright © 2020 Argentiero, Solimando, Ungaro, Laforgia, Strippoli, Pinto, Negri, Ferraiuolo, Zito and Guida http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Argentiero, Antonella
Solimando, Antonio Giovanni
Ungaro, Valentina
Laforgia, Mariarita
Strippoli, Sabino
Pinto, Dario
Negri, Antonio
Ferraiuolo, Simona
Zito, Alfredo
Guida, Michele
Case Report: Lymphocytosis Associated With Fatal Hepatitis in a Thymoma Patient Treated With Anti-PD1: New Insight Into the Immune-Related Storm
title Case Report: Lymphocytosis Associated With Fatal Hepatitis in a Thymoma Patient Treated With Anti-PD1: New Insight Into the Immune-Related Storm
title_full Case Report: Lymphocytosis Associated With Fatal Hepatitis in a Thymoma Patient Treated With Anti-PD1: New Insight Into the Immune-Related Storm
title_fullStr Case Report: Lymphocytosis Associated With Fatal Hepatitis in a Thymoma Patient Treated With Anti-PD1: New Insight Into the Immune-Related Storm
title_full_unstemmed Case Report: Lymphocytosis Associated With Fatal Hepatitis in a Thymoma Patient Treated With Anti-PD1: New Insight Into the Immune-Related Storm
title_short Case Report: Lymphocytosis Associated With Fatal Hepatitis in a Thymoma Patient Treated With Anti-PD1: New Insight Into the Immune-Related Storm
title_sort case report: lymphocytosis associated with fatal hepatitis in a thymoma patient treated with anti-pd1: new insight into the immune-related storm
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768075/
https://www.ncbi.nlm.nih.gov/pubmed/33381454
http://dx.doi.org/10.3389/fonc.2020.583781
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