title: Treatment possibilities of ipilimumab-induced thrombocytopenia--case study and literature review.
abstract: Recently, new drugs targeting the immune system have been introduced to the standard care of metastatic malignant melanoma. One of these immunomodulatory drugs is ipilimumab, a fully human monoclonal antibody that blocks cytotoxic T-lymphocyte antigen-4. The following case reports on a 54-year-old man with metastatic melanoma, who developed Grade 4 thrombocytopenia during treatment with ipilimumab already after first dose. Bone marrow examination confirmed a diagnosis of drug-induced, immune-mediated thrombocytopenia. Isolated thrombocytopenia has rarely been associated with ipilimumab and there is no standard treatment algorithm of such complication. This case demonstrates the importance of monitoring full blood count in all patients receiving ipilimumab and suggests a possible treatment algorithm.
authors.affiliation: Department of Clinical Oncology and Radiotherapy, University Hospital in Hradec Králové, Hradec Králové kopecjin@fnhk.cz.
authors.forename: Jindřich
authors.initials: J
authors.lastname: Kopecký
authors.affiliation: Department of Clinical Oncology and Radiotherapy, University Hospital in Hradec Králové, Hradec Králové
authors.forename: Petronela
authors.initials: P
authors.lastname: Trojanová
authors.affiliation: Department of Clinical Oncology and Radiotherapy, University Hospital in Hradec Králové, Hradec Králové
authors.forename: Ondřej
authors.initials: O
authors.lastname: Kubeček
authors.affiliation: Department of Clinical Immunology and Microbiology, Regional Hospital Náchod, Náchod, Czech Republic.
authors.forename: Otakar
authors.initials: O
authors.lastname: Kopecký
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D000074324:Ipilimumab; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000556:secondary; D008875:Middle Aged; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000556:secondary; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D016756:Immunoglobulins, Intravenous; D000074324:Ipilimumab
keywords: ipilimumab; melanoma; thrombocytopenia