Severe complicated neutropenia in two patients with metastatic non-small-cell lung cancer treated with nivolumab. Issue 7 (August 2017)

• Record Type: Journal Article
• Authors: Turgeman, Ilit; Wollner, Mira; Hassoun, Gamal; Bonstein, Lilach; Bar-Sela, Gil
• Is Part Of: Anti-cancer drugs. Volume 28:Issue 7(2017)
• Publication Date: 2017-08
• Subjects: autoimmune -- checkpoint inhibitor -- hematological toxicity -- immune-related adverse event -- immunotherapy -- lung cancer -- neutropenia -- nivolumab; Antineoplastic agents -- Periodicals; Cancer -- Chemotherapy -- Periodicals; Antineoplastic Agents -- therapeutic use -- Periodicals; Drug Therapy -- Periodicals; 616.994061
• DOI: 10.1097/CAD.0000000000000520
• Languages: English
• ISSNs: 0959-4973

Abstract

Abstract : Checkpoint inhibitors effectively enhance the natural immune response against cancer, but they are also known to induce a unique spectrum of immune-related adverse events. Here, we report the first case of isolated neutropenia subsequent to nivolumab therapy. Prominent activated T-cells were found in the patient's serum and bone marrow alongside evidence of maturational defects in neutrophil precursors. Antineutrophil antibodies were not detected despite reliable testing techniques. A T-cell-mediated response is probable, consistent with the established mechanism for the development of other immune-related toxicities. Awareness of this rare and severe side effect reinforces the importance of early diagnosis and prompt initiation of proper treatment.