Case Report: Successful Avatrombopag Treatment for Two Cases of Anti-PD-1 Antibody-Induced Acquired Amegakaryocytic Thrombocytopenia
Background: Anti-PD-1/PD-L1 immunotherapy has achieved impressive responses in multiple types of malignancies in recent years. However, immune-related adverse events (irAEs) occur and limit their continuous clinical use. Among these irAEs, acquired amegakaryocytic thrombocytopenia (AAT) is rare but...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-01-01
|
| Series: | Frontiers in Pharmacology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2021.795884/full |
| _version_ | 1798024745827958784 |
|---|---|
| author | Xiaofang Tu Ali Xue Suye Wu Mengmeng Jin Pu Zhao Hao Zhang |
| author_facet | Xiaofang Tu Ali Xue Suye Wu Mengmeng Jin Pu Zhao Hao Zhang |
| author_sort | Xiaofang Tu |
| collection | DOAJ |
| description | Background: Anti-PD-1/PD-L1 immunotherapy has achieved impressive responses in multiple types of malignancies in recent years. However, immune-related adverse events (irAEs) occur and limit their continuous clinical use. Among these irAEs, acquired amegakaryocytic thrombocytopenia (AAT) is rare but often clinically serious, life-threatening and refractory to multiple treatment approaches.Case summary: We reported for the first time the successful treatment of avatrombopag in two cases of anti-PD1 antibody-induced AAT (in particular, one case had progressed to aplastic anemia), which was refractory or intolerant to glucocorticoids, ciclosporin, intravenous immunoglobulin (IVIG), recombinant human thrombopoietin (rh-TPO) and even TPO receptor agonist (TPO-RA) eltrombopag. To date, the two cases manifested as normal platelet counts and are independent of transfusion.Conclusion: Anti-PD1 antibody-induced AAT occurs with low frequency but is often serious and difficult to manage, for which this study proposed vatrombopag as a potential curative and safe approach. |
| first_indexed | 2024-04-11T18:07:36Z |
| format | Article |
| id | doaj.art-76fc070e99fb47a7a92c309134ea06a5 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-11T18:07:36Z |
| publishDate | 2022-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-76fc070e99fb47a7a92c309134ea06a52022-12-22T04:10:16ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122022-01-011210.3389/fphar.2021.795884795884Case Report: Successful Avatrombopag Treatment for Two Cases of Anti-PD-1 Antibody-Induced Acquired Amegakaryocytic ThrombocytopeniaXiaofang TuAli XueSuye WuMengmeng JinPu ZhaoHao ZhangBackground: Anti-PD-1/PD-L1 immunotherapy has achieved impressive responses in multiple types of malignancies in recent years. However, immune-related adverse events (irAEs) occur and limit their continuous clinical use. Among these irAEs, acquired amegakaryocytic thrombocytopenia (AAT) is rare but often clinically serious, life-threatening and refractory to multiple treatment approaches.Case summary: We reported for the first time the successful treatment of avatrombopag in two cases of anti-PD1 antibody-induced AAT (in particular, one case had progressed to aplastic anemia), which was refractory or intolerant to glucocorticoids, ciclosporin, intravenous immunoglobulin (IVIG), recombinant human thrombopoietin (rh-TPO) and even TPO receptor agonist (TPO-RA) eltrombopag. To date, the two cases manifested as normal platelet counts and are independent of transfusion.Conclusion: Anti-PD1 antibody-induced AAT occurs with low frequency but is often serious and difficult to manage, for which this study proposed vatrombopag as a potential curative and safe approach.https://www.frontiersin.org/articles/10.3389/fphar.2021.795884/fullimmune-related adverse eventsacquired amegakaryocytic thrombocytopeniaanti-PD-1 antibodythrombopoietin receptor agonistsavatrombopag |
| spellingShingle | Xiaofang Tu Ali Xue Suye Wu Mengmeng Jin Pu Zhao Hao Zhang Case Report: Successful Avatrombopag Treatment for Two Cases of Anti-PD-1 Antibody-Induced Acquired Amegakaryocytic Thrombocytopenia Frontiers in Pharmacology immune-related adverse events acquired amegakaryocytic thrombocytopenia anti-PD-1 antibody thrombopoietin receptor agonists avatrombopag |
| title | Case Report: Successful Avatrombopag Treatment for Two Cases of Anti-PD-1 Antibody-Induced Acquired Amegakaryocytic Thrombocytopenia |
| title_full | Case Report: Successful Avatrombopag Treatment for Two Cases of Anti-PD-1 Antibody-Induced Acquired Amegakaryocytic Thrombocytopenia |
| title_fullStr | Case Report: Successful Avatrombopag Treatment for Two Cases of Anti-PD-1 Antibody-Induced Acquired Amegakaryocytic Thrombocytopenia |
| title_full_unstemmed | Case Report: Successful Avatrombopag Treatment for Two Cases of Anti-PD-1 Antibody-Induced Acquired Amegakaryocytic Thrombocytopenia |
| title_short | Case Report: Successful Avatrombopag Treatment for Two Cases of Anti-PD-1 Antibody-Induced Acquired Amegakaryocytic Thrombocytopenia |
| title_sort | case report successful avatrombopag treatment for two cases of anti pd 1 antibody induced acquired amegakaryocytic thrombocytopenia |
| topic | immune-related adverse events acquired amegakaryocytic thrombocytopenia anti-PD-1 antibody thrombopoietin receptor agonists avatrombopag |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2021.795884/full |
| work_keys_str_mv | AT xiaofangtu casereportsuccessfulavatrombopagtreatmentfortwocasesofantipd1antibodyinducedacquiredamegakaryocyticthrombocytopenia AT alixue casereportsuccessfulavatrombopagtreatmentfortwocasesofantipd1antibodyinducedacquiredamegakaryocyticthrombocytopenia AT suyewu casereportsuccessfulavatrombopagtreatmentfortwocasesofantipd1antibodyinducedacquiredamegakaryocyticthrombocytopenia AT mengmengjin casereportsuccessfulavatrombopagtreatmentfortwocasesofantipd1antibodyinducedacquiredamegakaryocyticthrombocytopenia AT puzhao casereportsuccessfulavatrombopagtreatmentfortwocasesofantipd1antibodyinducedacquiredamegakaryocyticthrombocytopenia AT haozhang casereportsuccessfulavatrombopagtreatmentfortwocasesofantipd1antibodyinducedacquiredamegakaryocyticthrombocytopenia |