Acquired amegakaryocytic thrombocytopenia after durvalumab administration
| العنوان: | Acquired amegakaryocytic thrombocytopenia after durvalumab administration |
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| المؤلفون: | Naoki Miyao, Takahiro Suyama, Yoko Shinka, Masao Hagihara, Naoto Kubota, Yoshiyuki Osamura |
| المصدر: | Journal of Clinical and Experimental Hematopathology : JCEH |
| بيانات النشر: | Japanese Society for Lymphoreticular Tissue Research, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Blood Platelets, Male, medicine.medical_specialty, Lung Neoplasms, Myeloid, immune-related thrombocytopenia, durvalumab, Biopsy, Eltrombopag, immune checkpoint inhibitor, Case Report, acquired amegakaryocytic thrombocytopenia, 030204 cardiovascular system & hematology, Gastroenterology, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Megakaryocyte, Bone Marrow, hemic and lymphatic diseases, Internal medicine, medicine, Humans, Platelet, Myelofibrosis, Bone Marrow Diseases, Immune Checkpoint Inhibitors, Aged, Thrombopoietin receptor, Platelet Count, business.industry, Antibodies, Monoclonal, General Medicine, medicine.disease, Immunohistochemistry, medicine.anatomical_structure, Platelet transfusion, Purpura, Thrombocytopenic, chemistry, 030220 oncology & carcinogenesis, Carcinoma, Squamous Cell, Bone marrow, eltrombopag, business, Megakaryocytes |
| الوصف: | Immune checkpoint inhibitors (ICIs), despite their ability to potentiate antitumor T-cell responses, may cause various immune-related adverse events. Most cases of thrombocytopenia induced by ICIs have revealed a pathophysiologic mechanism of immune thrombocytopenia with increased platelet destruction and preserved megakaryocytes. Acquired amegakaryocytic thrombocytopenic purpura (AATP) is an unusual disorder characterized by thrombocytopenia with markedly diminished bone marrow megakaryocytes in the presence of otherwise normal hematopoiesis. AATP caused by ICIs has not been reported on. Herein, we present the case of a 79-year-old man diagnosed with squamous cell carcinoma of the lung who developed AATP after two courses of durvalumab, a drug targeting programmed death-ligand 1. Two weeks after the second cycle, his platelet count decreased to 2.1 × 104/μL. After the patient underwent platelet transfusion, his platelet count increased to 8.1 × 104/μL the next day but subsequently decreased repeatedly even after the ICI was discontinued. Six weeks after the second cycle, he developed interstitial pneumonia and was administered prednisolone (50 mg/day). However, thrombocytopenia did not improve. Bone marrow biopsy showed scarce megakaryocytes (< 1 megakaryocyte/10 high-power fields) with preservation of myeloid and erythroid series. Myelodysplasia, myelofibrosis, or metastatic lesions were not observed. Cytogenetic analysis showed a normal male karyotype of 46XY. Hence, the patient received eltrombopag, a thrombopoietin receptor agonist, and his platelet count subsequently improved. After recovery, bone marrow aspiration revealed a normal number of megakaryocytes. AATP is rarely the type of thrombocytopenia induced by ICIs and may be successfully treated with thrombopoietin receptor agonists. |
| تدمد: | 1880-9952 1346-4280 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::19e9730920a35c04297eabc20d6d94ecTest https://doi.org/10.3960/jslrt.20047Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....19e9730920a35c04297eabc20d6d94ec |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 18809952 13464280 |
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