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

Case 1Case 2Case 3Case 4Case 5Case 6Case 7Case 8Case 9Case 10Case 11
Age, years/sex52/F80/M55/F44/M67/M45/F53/M48/F36/F56/M69/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 therapyPRPRPRPDN/APDN/ASDPDSDN/A
Time to TP onset, days1521506268431217340130151
Other irAEsNoneNeurologicalEndocrine, skinGINeurological, liverNoneNeurological, liverSkinNoneNoneNone
Counts at TP onset
WBC, 103/uLHCT, %PLT, 103/uL15.434Less than 55.843.5104737.86112.8N/A183.835.886640.7493.735.35311.931.3898.128.2584.94173428.574
% PLT decrease from baseline99%38%80%91%40%84%69%53%74%N/A75%
Signs and symptoms of TPHematochezia, petechiae, gingival bleeding, epistaxisNoneNoneEpistaxisBleeding from tumorNoneNoneNoneNoneNoneNone
Confirmation of ITPBone marrow biopsyPeripheral smear
Treatment 1/highest PLTMePRDL + IVIG/18None requiredNone requiredPrednisolone + IVIG/30Prednisone/118Prednisone/307None requiredNone requiredNone requiredNone requiredNone required
Treatment 2/highest PLTRituximab + prednisone/364None requiredNone requiredaPrednisone/269

Entries with “—” indicate not applicable to patient

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

aPatient relapsed after initial steroid treatment