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Case Reports
. 2022 Nov 15;14(11):e31552.
doi: 10.7759/cureus.31552. eCollection 2022 Nov.

Pembrolizumab-Induced Autoimmune Grade 4 Neutropenia in a Patient With Advanced Bladder Cancer: A Case Report

Mafalda Miranda Baleiras  1 , Carolina Vasques  1 , Marta Pinto  2 , Helena Miranda  1 , Ana Martins  1
Affiliations
Case Reports

Pembrolizumab-Induced Autoimmune Grade 4 Neutropenia in a Patient With Advanced Bladder Cancer: A Case Report

Mafalda Miranda Baleiras et al. Cureus. .

Abstract

Neutropenia is amongst the rare, but potentially life-threatening complications of immune checkpoint inhibitors (ICI). Awareness about this dangerous toxicity and its adequate treatment since early detection is of utmost importance. Unfortunately, there are no therapeutical guidelines to deal with neutropenia specifically. The best alternative is informed extrapolations based on reported neutropenia cases and established guidelines for other immune-related adverse events. We report a case of pembrolizumab-related grade 4 neutropenia in a patient with metastatic bladder cancer. She was successfully treated with immunosuppressive and supportive measures. Further studies are required to understand the range of immune-related adverse events and to improve their management.

Keywords: bladder cancer; immune-checkpoint inhibitors; immune-related adverse effects; neutropenia; pembrolizumab.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Treatment course and absolute neutrophil count over time
Therapeutics received and major events are described along with their timeline. CS: corticosteroids.
See this image and copyright information in PMC

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