Immunotherapy-Associated Hemolytic Anemia with Pure Red-Cell Aplasia

Nair, Ranjit; Gheith, Shereen M F; Nair, Suresh

doi:10.1056/nejmc1509362

Cited by 74 publications

(62 citation statements)

References 3 publications

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“…Toxicities were nonoverlapping with the exception of four ICSRs with ITP and concurrent HA, consistent with Evan's syndrome. There was also one patient who developed both PRCA and warm AIHA . Concurrent, nonhematologic irAEs occurred in 23% of these patients.…”

Section: Resultsmentioning

confidence: 98%

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Hematologic Complications of Immune Checkpoint Inhibitors

et al. 2019

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Section: Resultsmentioning

confidence: 98%

“…A number of isolated case reports and case series have demonstrated that uncommon severe and even fatal hematologic toxicities may complicate immune checkpoint inhibitor therapy . However, no series has evaluated more than 10 cases; thus, the timing, spectrum, and clinical presentation of hematologic irAEs are poorly understood.…”

Section: Introductionmentioning

confidence: 99%

Hematologic Complications of Immune Checkpoint Inhibitors

et al. 2019

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“…Red cell aplasia, acquired hemophilia A, and thrombocytopenia have all been described as well [4,13]. Recently, cases of hemolytic-uremic syndrome occurring in a patient receiving ipilimumab have been reported [50]. Generally, hematological immune-related adverse events respond to steroid therapy, but in severe cases, may need more intense therapy.…”

Section: Hematologicalmentioning

confidence: 99%

Management and Supportive Care of Patients Undergoing Immunotherapy

Rapoport¹,

Eeden²

2017

Immunotherapy - Myths, Reality, Ideas, Future

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In many tumor types, where the prognosis was shown to be extremely dismal before, immunotherapy is now a new beacon of hope to many patients. Immunotherapy has been approved for use in a many diferent cancers including metastatic melanoma, advanced non-small cell lung cancer, metastatic renal cell carcinoma, refractory Hodgkin's lymphoma, metastatic bladder cancer advanced head and neck cancer, and the list keeps growing each day. It seems to be generally beter tolerated in most patients and less toxic compared to what we have seen in diferent anticancer treatments from before. However, the toxicities here are termed immune-related adverse events. There is almost no prospective data on these toxicities, and guidelines or recommendations are mostly based on symptomatic management from the ongoing clinical trials. Treating oncologists need to be aware of the subtleties in presentation and the huge diference in the way we mange these side efects. Although most adverse events are low-grade and manageable, they have the potential to be life-threatening if not treated promptly. In this chapter, we address the diferent immune-related adverse events relating to the organ system they can involve, presentation and symptomatology, general recommendations of management, and individual toxicities. Keywords: immunotherapy, PD-1, CTLA-4.

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“…In some patients, AIHA relapses after premature cessation of steroids, but reapplication is still effective. Although AIHA presents a benign process as a whole, ICIs should be discontinued during the administration of steroids . Other immune suppressor therapies are not recommended because most cases of AIHA recover with single steroid treatment.…”

Section: Introductionmentioning

confidence: 99%

Clinical diagnosis and treatment recommendations for immune checkpoint inhibitor‐related hematological adverse events

Zhuang

Guo

et al. 2020

Thoracic Cancer

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Immune checkpoint inhibitors (ICIs) are able to reactivate the immune system, thereby enhancing the anti‐tumor effects. However, over‐activated T cells may induce immune‐related adverse events (irAEs). Hematological irAEs are rarely reported which mainly represent monolineage cytopenia or pancytopenia, including autoimmune hemolytic anemia (AIHA), immune thrombocytopenia (ITP), neutropenia and aplastic anemia, sometimes even life‐threatening diseases such as hemophagocytic lymphohistiocytosis. Here, the clinical manifestations of hematological irAEs are summarized and recommendations for diagnosis and treatment proposed. Key points Significant findings of the study• Hematological immune‐related adverse events (irAEs) caused by checkpoint inhibitors are rare and may sometimes be life‐threatening. This study summarizes the manifestations of hematological irAEs and proposes preliminary recommendations for diagnosis and treatment. What this study adds• Much still remains unknown regarding hematological irAEs caused by checkpoint inhibitors. This study delineates the overview of hematological irAEs, and provides practical treatment suggestions, in particular addressing the issue of rechallenge.

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Immunotherapy-Associated Hemolytic Anemia with Pure Red-Cell Aplasia

Cited by 74 publications

References 3 publications

Hematologic Complications of Immune Checkpoint Inhibitors

Hematologic Complications of Immune Checkpoint Inhibitors

Management and Supportive Care of Patients Undergoing Immunotherapy

Clinical diagnosis and treatment recommendations for immune checkpoint inhibitor‐related hematological adverse events

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