A case of autosplenectomy associated with T-cell checkpoint inhibitor treatment

Delahunty, Rachel; Lee, Margaret; Datta, Mineesh; Parente, Phillip

doi:10.1136/bcr-2017-220775

Cited by 3 publications

(3 citation statements)

References 2 publications

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“…Here we present a rare case of auto-splenectomy with the use of ipilimumab and nivolumab. Only one similar case has been reported in the published literature; a 77-year-old caucasian male was treated for metastatic melanoma with ipilimumab and nivolumab and later was found to have complete regression of the spleen [6]. In our case, a 55-year-old Caucasian female with metastatic disease was treated with four cycles of ipilimumab and nivolumab and later was switched to nivolumab maintenance therapy for 14 cycles.…”

Section: Discussionsupporting

confidence: 52%

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Immunotherapy-Induced Auto-Splenectomy in a Patient of Malignant Melanoma

Ehsanullah¹,

Azharuddin²,

Hasan³

et al. 2022

Cureus

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Immune checkpoint inhibitors like programmed cell death 1 (PD-1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) are biological agents that help in boosting the immune system of the body to fight against cancer cells. These checkpoint inhibitors are now being approved by the Food and Drug Administration (FDA) to treat various malignancies due to remarkable response. Here, we present a rare immune-related adverse event in a 77-year-old female with metastatic melanoma treated with ipilimumab and nivolumab, later presented with auto-splenectomy.

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Section: Discussionsupporting

confidence: 52%

“…Autosplenectomy is an extremely rare complication and adverse event of ipilimumab and nivolumab. So far, only one case has been reported in the published literature [6].…”

Section: Introductionmentioning

confidence: 99%

Immunotherapy-Induced Auto-Splenectomy in a Patient of Malignant Melanoma

Ehsanullah¹,

Azharuddin²,

Hasan³

et al. 2022

Cureus

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“…CD8 + T cells in the spleen are highly involved in mounting systemic immune responses [32,33], but are also important in the immune tolerance of tumors [34]. Additionally, the rare cases of autosplenectomy associated with ICT suggest a strong involvement of the spleen [35,36]. Besides T cells, littoral cells, which are lining the sinusoidal structures of the red pulp in the spleen, express high levels of CD8, although the heritage or the functional significance of the CD8 expression is unknown in these cells [37,38].…”

Section: Introductionmentioning

confidence: 99%

In vivo imaging of CD8⁺ T cells in metastatic cancer patients: first clinical experience with simultaneous [⁸⁹Zr]Zr-Df-IAB22M2C PET/MRI

Schwenck¹,

Sonanini²,

Seyfried³

et al. 2023

Theranostics

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Aim/Introduction: Despite the spectacular success of immune checkpoint inhibitor therapy (ICT) in patients with metastatic cancer, only a limited proportion of patients benefit from ICT. CD8 + cytotoxic T cells are important gatekeepers for the therapeutic response to ICT and are able to recognize MHC class I-dependent tumor antigens and destroy tumor cells. The radiolabeled minibody [ 89 Zr]Zr-Df-IAB22M2C has a high affinity for human CD8 + T cells and was successfully tested in a phase I study. Here, we aimed to gain the first clinical PET/MRI experience with the noninvasive assessment of the CD8 + T-cell distribution in cancer patients by in vivo [ 89 Zr]Zr-Df-IAB22M2C with a distinct focus of identifying potential signatures of successful ICT. Material and Methods:We investigated 8 patients with metastasized cancers undergoing ICT. Radiolabeling of Df-IAB22M2C with Zr-89 was performed according to Good Manufacturing Practice. Multiparametric PET/MRI was acquired 24 h after injection of 74.2±17.9 MBq [ 89 Zr]Zr-Df-IAB22M2C. We analyzed [ 89 Zr]Zr-Df-IAB22M2C uptake within the metastases and within primary and secondary lymphatic organs. Results: [ 89 Zr]Zr-Df-IAB22M2C injection was tolerated well without noticeable side effects. The CD8 PET/MRI data acquisitions 24 hours post-administration of [ 89 Zr]Zr-Df-IAB22M2C revealed good image quality with a relatively low background signal due to only low unspecific tissue uptake and marginal blood pool retention. Only two metastatic lesions showed markedly increased tracer uptake in our cohort of patients. Furthermore, we observed high interpatient variability in [ 89 Zr]Zr-Df-IAB22M2C uptake within the primary and secondary lymphoid organs. Four out of five ICT patients exhibited rather high [ 89 Zr]Zr-Df-IAB22M2C uptake in the bone marrow. Two of these four patients as well as two other patients yielded pronounced [ 89 Zr]Zr-Df-IAB22M2C uptake within nonmetastatic lymph nodes. Interestingly, cancer progression in ICT patients was associated with a relatively low [ 89 Zr]Zr-Df-IAB22M2C uptake in the spleen compared to the liver in 4 out of the 6 patients. Lymph nodes with enhanced [ 89 Zr]Zr-Df-IAB22M2C uptake revealed significantly reduced apparent diffusion coefficient (ADC) values in diffusion weighted MRI. Conclusion: Our first clinical experiences revealed the feasibility of [ 89 Zr]Zr-Df-IAB22M2C PET/MRI in assessing potential immune-related changes in metastases and primary and secondary lymphatic organs.

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Ipilimumab/nivolumab

2017

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A case of autosplenectomy associated with T-cell checkpoint inhibitor treatment

Cited by 3 publications

References 2 publications

Immunotherapy-Induced Auto-Splenectomy in a Patient of Malignant Melanoma

Immunotherapy-Induced Auto-Splenectomy in a Patient of Malignant Melanoma

In vivo imaging of CD8⁺ T cells in metastatic cancer patients: first clinical experience with simultaneous [⁸⁹Zr]Zr-Df-IAB22M2C PET/MRI

Ipilimumab/nivolumab

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A case of autosplenectomy associated with T-cell checkpoint inhibitor treatment

Cited by 3 publications

References 2 publications

Immunotherapy-Induced Auto-Splenectomy in a Patient of Malignant Melanoma

Immunotherapy-Induced Auto-Splenectomy in a Patient of Malignant Melanoma

In vivo imaging of CD8+ T cells in metastatic cancer patients: first clinical experience with simultaneous [89Zr]Zr-Df-IAB22M2C PET/MRI

Ipilimumab/nivolumab

Contact Info

Product

Resources

About

In vivo imaging of CD8⁺ T cells in metastatic cancer patients: first clinical experience with simultaneous [⁸⁹Zr]Zr-Df-IAB22M2C PET/MRI