Severe agranulocytosis in a patient with metastatic non-small-cell lung cancer treated with nivolumab

Lung Cancer. 2016 Sep:99:123-6. doi: 10.1016/j.lungcan.2016.06.026. Epub 2016 Jul 1.

Abstract

Immune checkpoint inhibitors are novel agents in the process of revolutionising cancer care. These agents have become a very appealing therapeutic alternative since they are much better tolerated than cytotoxic therapy, due to their relatively favorable toxicity profile. However, adverse events associated with these agents usually involve the immune system and can have serious implications jeopardising survival. Herein we report the first case of immune-mediated agranulocytosis due to Nivolumab therapy. The patient suffered from Staphylococcus infection during her agranulocytosis which only responded to high dose corticosteroid therapy.

Keywords: Agranulocytosis; Immune checkpoint inhibitors; Immune-mediated adverse events; Neutropenia; Nivolumab.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Agranulocytosis / diagnosis*
  • Agranulocytosis / drug therapy
  • Agranulocytosis / etiology*
  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal / therapeutic use
  • Antineoplastic Agents, Immunological / adverse effects*
  • Antineoplastic Agents, Immunological / therapeutic use
  • Bone Marrow / pathology
  • Carcinoma, Non-Small-Cell Lung / complications*
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Ecthyma / diagnosis
  • Ecthyma / etiology
  • Female
  • Health Status Indicators
  • Humans
  • Leukocyte Count
  • Liver Function Tests
  • Lung Neoplasms / complications*
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / pathology
  • Neoplasm Metastasis
  • Neoplasm Staging
  • Nivolumab

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents, Immunological
  • Nivolumab