title: Ipilimumab-induced thrombocytopenia in a patient with metastatic melanoma.
abstract: A 57-year-old man with metastatic melanoma developed grade 4 thrombocytopenia during treatment with ipilimumab (anti-CTLA-4 antibody). Bone marrow examination confirmed increased megakaryocytes, which supported a diagnosis of drug-induced, immune-mediated thrombocytopenia and he received 1 mg/kg prednisolone and 1 g/kg intravenous immunoglobulin. There was a delayed response to treatment, with the first evidence of rise in platelet count seen after 9 days. This was followed by a complete and sustained resolution of thrombocytopenia. Hematological toxicity has rarely been associated with ipilimumab and to our knowledge this is the first report of isolated grade 4 thrombocytopenia. This case demonstrates the importance of monitoring full blood count in all patients receiving ipilimumab.
authors.affiliation: Addenbrooke's Hospital, Cambridge, UK.
authors.forename: S
authors.initials: S
authors.lastname: Ahmad
authors.forename: M
authors.initials: M
authors.lastname: Lewis
authors.forename: P
authors.initials: P
authors.lastname: Corrie
authors.forename: M
authors.initials: M
authors.lastname: Iddawela
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D006801:Humans; D000074324:Ipilimumab; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary*; D008875:Middle Aged; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000175:diagnosis* / Q000473:pathology
chemical_list: D000911:Antibodies, Monoclonal; D000074324:Ipilimumab