TY - JOUR
T1 - Durvalumab-induced Pure White Cell Aplasia
AU - Lin, Ji
AU - Rodriguez-Martinez, Paola
AU - Oo, Thein Hlaing
AU - Shuyu, E.
AU - Jorgensen, Jeffrey
AU - Rojas-Hernandez, Cristhiam M.
N1 - Publisher Copyright:
© 2024 Lippincott Williams and Wilkins. All rights reserved.
PY - 2024/1/1
Y1 - 2024/1/1
N2 - Immune checkpoint inhibitors (ICI) have gained approval as a treatment for a wide array of cancers. Their mechanism of action prevents the inactivation of cytotoxic T-cells, allowing for its cytotoxic response. However, the upregulation of the immune system by ICI also leads to many undesired adverse events known as immune-related adverse events (irAEs), ranging from dermatologic manifestations, such as rashes, to inflammation of mucous membranes, to hematologic toxicities. Here, we report a case of ICI-induced pure white cell aplasia, secondary to the agent durvalumab, which responded to treatment with filgrastim, prednisone, and cyclosporine. ICI-neutropenia accounts for 0.6% of all irAEs or 17% of hematologic irAEs. Given the rarity of hematologic irAEs, the available treatment guidelines are based on expert consensus. As ICI becomes more widely used, we can expect an increase in the prevalence of rare irAEs as well. This case report aims to present a rare side effect of ICI and demonstrate its response to immunosuppressive therapy while providing guidance for future clinicians and further elucidating the mechanism behind these irAEs.
AB - Immune checkpoint inhibitors (ICI) have gained approval as a treatment for a wide array of cancers. Their mechanism of action prevents the inactivation of cytotoxic T-cells, allowing for its cytotoxic response. However, the upregulation of the immune system by ICI also leads to many undesired adverse events known as immune-related adverse events (irAEs), ranging from dermatologic manifestations, such as rashes, to inflammation of mucous membranes, to hematologic toxicities. Here, we report a case of ICI-induced pure white cell aplasia, secondary to the agent durvalumab, which responded to treatment with filgrastim, prednisone, and cyclosporine. ICI-neutropenia accounts for 0.6% of all irAEs or 17% of hematologic irAEs. Given the rarity of hematologic irAEs, the available treatment guidelines are based on expert consensus. As ICI becomes more widely used, we can expect an increase in the prevalence of rare irAEs as well. This case report aims to present a rare side effect of ICI and demonstrate its response to immunosuppressive therapy while providing guidance for future clinicians and further elucidating the mechanism behind these irAEs.
KW - durvalumab
KW - immune-related adverse events
KW - pure white cell aplasia
UR - http://www.scopus.com/inward/record.url?scp=85179470429&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85179470429&partnerID=8YFLogxK
U2 - 10.1097/CJI.0000000000000491
DO - 10.1097/CJI.0000000000000491
M3 - Article
C2 - 37904601
AN - SCOPUS:85179470429
SN - 1524-9557
VL - 47
SP - 7
EP - 9
JO - Journal of Immunotherapy
JF - Journal of Immunotherapy
IS - 1
ER -