Neutropenia in a Patient Treated With Ipilimumab (anti-CTLA-4 Antibody)
Neutropenia in a Patient Treated With Ipilimumab (anti-CTLA-4 Antibody)
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DOI：
10.1097/cji.0b013e31819aa40b
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发表时间：
2009-04-01
影响因子：
3.9
通讯作者：
Arellano, Martha L.
中科院分区：
文献类型：
--
作者：
Akhtari, Mojtaba;Waller, Edmund K.;Arellano, Martha L.
一名诊断为转移性黑色素瘤的42岁白色女性患者在接受伊匹单抗（抗细胞毒性T淋巴细胞相关抗原-4抗体）治疗期间发生重度中性粒细胞减少症。骨髓穿刺和活检标本显示明显的骨髓发育不全，伴不明显的红细胞生成和巨核细胞生成。患者的中性粒细胞减少症对集落刺激因子和类固醇的联合治疗无反应：然而，在静脉注射免疫球蛋白后迅速改善。尚未报告使用易普利姆玛治疗与血液学毒性相关，并且据我们所知，先前未报告中性粒细胞减少症病例。这份与易普利姆玛相关的急性4级中性粒细胞减少症的报告，在临床上与自身免疫过程一致，强调了在使用这种新的单克隆抗体治疗期间监测全血细胞计数的重要性。
A 42-year-old white woman with a diagnosis Of metastatic melanoma developed severe neutropenia during treatment with ipilimumab (anticytotoxic T-lymphocyte-associated antigen-4 antibody), Bone marrow aspiration and biopsy specimens revealed marked myeloid hypoplasia, with unremarkable erythropoiesis and megakaryopoiesis. The patient's neutropenia did not respond to therapy with a combination of colony stimulating factors and steroids: however, it rapidly improved after administration of intravenous immunoglobulin. Treatment With ipilimumab has not been reported to be associated with hematologic toxicities, and to our knowledge, no case of neutropenia has previously been reported. This report of acute grade 4 neutropenia associated with ipilimumab and clinically consistent with an autoimmune process emphasizes the importance of monitoring complete blood count during treatment with this, new monoclonal antibody.