Case Report: Lymphocytosis Associated With Fatal Hepatitis in a Thymoma Patient Treated With Anti-PD1: New Insight Into the Immune-Related Storm.

Antonella Argentiero, Antonio Giovanni Solimando, Valentina Ungaro, Mariarita Laforgia, Sabino Strippoli, Dario Pinto, Antonio Negri, Simona Ferraiuolo, Francesco Alfredo Zito, Michele Guida

Research output: Contribution to journalArticlepeer-review

Abstract

Recent advances in tumor immunotherapy have made it possible to efficiently unleash immune effectors, reacting against neoplastic cells. Although these approaches primarily aim to eradicate malignancy, immune-related adverse events (irAEs) often influence patients’ prognosis, constituting a new spectrum of side effects. Taking into account the typical microenvironment and the intricate equilibrium between the anti-tumor response and the immune cells, the thymoma constitutes a unicum in the immune-oncology field. We report a fatal immune-mediated adverse events’ storm in a thymoma patient treated with Pembrolizumab, leading to hepatotoxicity accompanied by lymphocytosis, thrombocytopenia, and thyroid dysfunction, unveiling a novel potential pathophysiological effect of immunotherapy. The clinical proficiency of the immune checkpoint inhibitors in thymoma patients warrants timely prevention and management of off-target consequences in order to optimize this promising therapeutic option. This case report describes a unique consequence of irAEs, emerging as a red flag warranting a multidisciplinary approach.

Original languageEnglish
Article number583781
JournalFrontiers in Oncology
Volume10
DOIs
Publication statusPublished - Dec 14 2020

Keywords

  • hepatitis
  • immune related adverse events
  • immune-microenvironment
  • immunotherapy
  • lymphocytosis
  • pembrolizumab
  • thymoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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