Unexpected serious aplastic anemia from PD-1 inhibitors: beyond what we know

Tumori. 2019 Dec;105(6):NP48-NP51. doi: 10.1177/0300891619856197. Epub 2019 Jun 21.

Abstract

Introduction: The recent introduction of checkpoint inhibitor-based immunotherapy has revolutionized the treatment of advanced lung cancers, becoming standard of care in both first- and second-line treatment. New types of toxicity are emerging with the increasingly widespread use of these inhibitors.

Case presentation: We describe a case of aplastic anemia in a patient with stage IV non-small cell lung cancer after a single administration of nivolumab.

Conclusions: Several similar case reports reported in literature show an increasing rate of toxicities from immunotherapy in this setting. These real-world data provide an insight into patient outcomes and treatment decisions being made in clinical practice.

Keywords: Nivolumab; aplastic anemia; immunotherapy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anemia, Aplastic / diagnosis*
  • Anemia, Aplastic / etiology*
  • Anemia, Aplastic / therapy
  • Antineoplastic Agents, Immunological / adverse effects*
  • Antineoplastic Agents, Immunological / therapeutic use
  • Biopsy
  • Bone Marrow / pathology
  • Carcinoma, Non-Small-Cell Lung / complications
  • Carcinoma, Non-Small-Cell Lung / diagnosis
  • Carcinoma, Non-Small-Cell Lung / drug therapy
  • Combined Modality Therapy
  • Erythrocyte Indices
  • Female
  • Humans
  • Lung Neoplasms / complications
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / drug therapy
  • Neoplasm Staging
  • Nivolumab / adverse effects*
  • Nivolumab / therapeutic use
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors
  • Treatment Outcome

Substances

  • Antineoplastic Agents, Immunological
  • Programmed Cell Death 1 Receptor
  • Nivolumab