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Table 1 Patients with thrombocytopenia and/or confirmed new-onset ITP following checkpoint inhibitor therapy for melanoma

From: Thrombocytopenia in patients with melanoma receiving immune checkpoint inhibitor therapy

  Case 1 Case 2 Case 3 Case 4 Case 5 Case 6 Case 7 Case 8 Case 9 Case 10 Case 11
Age, years/sex 52/F 80/M 55/F 44/M 67/M 45/F 53/M 48/F 36/F 56/M 69/M
Checkpoint inhibitor(s) and dosage(s) Ipi (3 mg/kg) +
nivo (1 mg/kg)
Pembro
(2 mg/kg)
Ipi (3 mg/kg) + nivo
(1 mg/kg)
Ipi
(3 mg/kg)
Ipi (3 mg/kg) + nivo
(1 mg/kg)
Nivo
(3 mg/kg)
Pembro
(2 mg/kg)
Pembro
(2 mg/kg)
Pembro
(2 mg/kg)
Nivo
(3 mg/kg)
Nivo
(3 mg/kg)
Best response to therapy PR PR PR PD N/A PD N/A SD PD SD N/A
Time to TP onset, days 15 21 50 62 68 43 12 173 40 130 151
Other irAEs None Neurological Endocrine, skin GI Neurological, liver None Neurological, liver Skin None None None
Counts at TP onset            
WBC, 103/uL
HCT, %
PLT, 103/uL
15.4
34
Less than 5
5.8
43.5
104
7
37.8
61
12.8
N/A
18
3.8
35.8
86
6
40.7
49
3.7
35.3
53
11.9
31.3
89
8.1
28.2
58
4.9
41
73
4
28.5
74
% PLT decrease from baseline 99% 38% 80% 91% 40% 84% 69% 53% 74% N/A 75%
Signs and symptoms of TP Hematochezia, petechiae, gingival bleeding, epistaxis None None Epistaxis Bleeding from tumor None None None None None None
Confirmation of ITP Bone marrow biopsy Peripheral smear
Treatment 1/highest PLT MePRDL + IVIG/18 None required None required Prednisolone + IVIG/30 Prednisone/118 Prednisone/307 None required None required None required None required None required
Treatment 2/highest PLT Rituximab + prednisone/364 None required None required aPrednisone/269
  1. Entries with “—” indicate not applicable to patient
  2. Ipi ipilimumab, Nivo nivolumab, Pembro pembrolizumab, PR partial response, PD progression of disease, SD stable disease, N/A not available, TP thrombocytopenia, GI gastrointestinal, irAEs immune-related adverse events, WBC white blood count, HCT hematocrit, PLT platelet, MePRDL methylprednisolone, IVIG intravenous immunoglobulin
  3. aPatient relapsed after initial steroid treatment