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 | — | — | — | — | — |