Acquired thrombotic thrombocytopenic purpura during durvalumab monotherapy for non-small cell lung cancer

• Published in: Rinshō ketsueki Vol. 65; no. 1; p. 24
• Main Authors: Shimada, Shotaro, Kuroiwa, Kai, Narita, Hinako, Okamura, Reiko, Uesugi, Yuka, Sasaki, Yohei, Watanuki, Megumi, Arai, Nana, Kawaguchi, Yukiko, Fujiwara, Shun, Yanagisawa, Koji, Hattori, Norimichi
• Format: Journal Article
• Language: Japanese
• Published: Japan 2024
• Subjects: Aged; Antibodies, Monoclonal - adverse effects; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - etiology; Female; Humans; Lung Neoplasms - drug therapy; Lung Neoplasms - etiology; Plasma Exchange - adverse effects; Purpura, Thrombotic Thrombocytopenic - chemically induced; Purpura, Thrombotic Thrombocytopenic - diagnosis; Purpura, Thrombotic Thrombocytopenic - therapy; irAE; Durvalumab; Thrombotic thrombocytopenic purpura
• ISSN: 0485-1439
• DOI: 10.11406/rinketsu.65.24

Immune checkpoint inhibitor (ICI)-induced thrombocytopenias are rare immune-related adverse events (irAE), but ICI-related thrombotic thrombocytopenic purpura (TTP) is extremely rare. A 79-year-old woman with non-small cell lung cancer received maintenance therapy with the anti-human PD-L1 monoclonal antibody durvalumab. Four weeks after the last infusion, she developed overt TTP. Remission was achieved by plasma exchange and prednisolone, and the patient has now been recurrence-free for over 12 months. To our knowledge, this is the first report of TTP occurring as an irAE of durvalumab.