Immune checkpoint inhibitors (ICIs) represent a primary milestone in cancer treatment.
Meanwhile, their immune-related adverse events (irAEs) in clinical practice have been
given more and more concerns; particularly haematological irAEs (haem-irAEs) are relatively
rare but potentially life-threatening events [
[1]
]. By reviewing the 63 reported cases with haem-irAEs in the published literature,
Michot et al. [
[2]
] investigated the distribution of haem-irAEs and also indicated the pathophysiological
aspects and clinical management of haem-irAEs. Among these haem-irAEs, the distribution
of immune thrombocytopenia (ITP) was 29% [
[2]
]. In a recent descriptive observation study, Delanoy et al. [
[3]
] also demonstrated that ITP accounted for 26% of these haem-irAEs induced by Programmed
cell death (PD-1) and programmed cell death ligand 1 (PD-L1) inhibitors. Therefore,
ITP was the most common type of haem-irAEs, but the authors of this review did not
adequately discuss the pathogenesis and management of ITP induced by ICIs.To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to European Journal of CancerAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Hematologic complications of immune checkpoint inhibitors.Oncol. 2019; 24: 584-588
- Haematological immune-related adverse events with immune checkpoint inhibitors, how to manage?.Eur J Canc. 2019; 122: 72-90
- Haematological immune-related adverse events induced by anti-PD-1 or anti-PD-L1 immunotherapy: a descriptive observational study.Lancet Haematol. 2019; 6: e48-e57
- Impact of risk factors on the occurrence of arterial thrombosis and venous thromboembolism in adults with primary immune thrombocytopenia - results from two nationwide cohorts.Thromb Res. 2019; 178: 124-131
- PD-1/PD-L pathway potentially involved in ITP immunopathogenesis.Thromb Haemostasis. 2019; 119: 758-765
- Immune-mediated thrombocytopenia and hypothyroidism in a lung cancer patient treated with nivolumab.Immunotherapy. 2018; 10: 85-91
- Immune thrombocytopenia-A neglected adverse event of PD-1 and PD-L1 inhibitors in clinical trials.JAMA Oncol. 2019 Sep 19; https://doi.org/10.1001/jamaoncol.2019.3599
Article info
Publication history
Published online: April 02, 2020
Accepted:
February 13,
2020
Received:
December 30,
2019
Identification
Copyright
© 2020 Elsevier Ltd. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Haematological immune-related adverse events with immune checkpoint inhibitors, how to manage?European Journal of CancerVol. 122
- PreviewImmune checkpoint inhibitors (ICIs) are changing the treatments of many patients with cancer. These immunotherapies are generally better tolerated than chemotherapy, and their adverse events are immune-related mimicking autoimmune or inflammatory conditions. Although these immune-related adverse events mainly affect the skin, endocrine glands, digestive tract, joints, liver or lungs, all the organs can be theoretically affected, and the haematopoietic system is not spared. This review of the literature will focus on the haematological immune-related adverse events (Haem-irAEs).
- Full-Text
- Preview
- Letter responds to the comment in ‘immune thrombocytopenia of haematological immune-related adverse events in cancer immunotherapy: Most and mighty’European Journal of CancerVol. 134
- PreviewWe thank Xiaocong Pang et al [1] for their comment and interests on the recently published literature review on haematological immune-related adverse events induced by immune checkpoints inhibitors [2]. The additional information provided on the hypotheses of the pathogenesis of immune thrombocytopenia induced by immunotherapy is nicely exposed in Fig. 1. We agree with the mechanisms suggested, which can involve direct destruction of autologous platelets by TCD8+ cytotoxic lymphocytes, by splenic macrophages throughout the activation of Fcg receptor, with the production of anti-platelet autoantibodies from autoreactive B lymphocytes and plasma cells, and probably by a combination of these mechanisms.
- Full-Text
- Preview
