Citations 2
Immune thrombocytopenia in patients treated with immune checkpoint inhibitors
Leaf, Rebecca Karp , Mones, Jodi V. , Shenoy, Tushar , Warsame, Mohamed , Moreira, Marina Beltrami , Panch, Sandhya , Leavitt, Andrew D., Zon, Rebecca L. , Shahamatdar, Sahar , Lim, Tristan , Cui, Can , Jiang, Debbie , Kaunfer, Sarah Allison , Durai, Lavanya , Hoge, Steven T., Dias, Julie‐Alexia , Sha, Carrie , Holmes, Aaron , Easton, Neil , Corley, Elizabeth M. , Zhao, Ethan, Li, Xingyi , Spelman, Amy, Amos, Christina Briggs, Soebbing, Doris, Shabih, Maria, Jamison, Trevor , Liu, Bolun , Hussein, Guleid , Yadav, Sumeet K. , Meara, Alexa, Juras, Patrick K. , Heskel, Marina, Reynolds, Kerry L. , Kroll, Michael H. , Leaf, David E. , Leaf, Rebecca K , Beltrami-Moreira, Marina , Cui, Can , Jiang, Debbie , Kaunfer, Sarah A , Durai, Lavanya , Dias, Julie-Alexia , Holmes, Aaron N , Easton, Neela , Corley, Elizabeth M , Liu, Bolun , Yadav, Sumeet Kumar , Elsaid, Mohamed I , Suresh, Arvind , Huang, Jennifer J , Glezerman, Ilya G , Al-Samkari, Hanny , Kroll, Michael H , Leaf, David E , Leavitt, Andrew D. , Kendall, Ellen K. , Hoge, Steven T., Li, Xingyi, Amos, Christina Briggs, Owen, Dwight H , Meara, Alexa, Go, Ronald S. , Al‐Samkari, Hanny
Blood | December 8, 2025 | Volume: 147 | Issue: 12 | Pages: 1351-1364
Abstract Immune checkpoint inhibitor–associated immune thrombocytopenia (ICI-ITP) has been described in case reports and small case series, but comprehensive data on its incidence, risk factors, clinical features, treatment, and outcomes are lacking. We reviewed medical records of all adults initiating ICI therapy between 2016 and 2023 at 29 US hospitals across 7 major cancer centers to identify patients with ICI-ITP. Multivariable logistic regression was used to identify risk factors, and Cox modeling was performed to assess the association between ICI-ITP, its severity, and mortality. Among 86 467 patients, ICI-ITP occurred in 214 (0.25%). Independent risk factors included lower baseline platelet count, combination ICI therapy, stage IV cancer, and additional immune-related adverse events. ICI-ITP occurred at a median of 8 weeks (interquartile range [IQR], 4-18) after ICI initiation, with a median nadir platelet count of 41 × 109/L (IQR, 17 × 109/L to 64 × 109/L). Patients were treated with glucocorticoids (n = 106 [49.5%]), immune globulin (n = 39 [18.2%]), and thrombopoietin receptor agonists (n = 29 [13.6%]). Recovery occurred in 161 patients (75.2%) at a median of 2.3 weeks (IQR, 1.0-5.3). Of 76 patients rechallenged with ICIs, 23 (30.3%) developed recurrent ICI-ITP. ICI-ITP and its severity were associated with higher all-cause mortality, with a nearly threefold increase in risk among patients with severe ICI-ITP than those without ICI-ITP (adjusted hazard ratio, 2.96 [95% confidence interval, 2.14-4.08]). These findings establish ICI-ITP as a rare but clinically significant complication of ICI therapy, provide, to our knowledge, the first large-scale description of its risk factors and clinical course, and underscore the importance of timely recognition and management.
Cancer-Associated Venous Thromboembolic Disease, Version 2.2024, NCCN Clinical Practice Guidelines in Oncology
Streiff, Michael B. , Holmstrom, Bjorn, Angelini, Dana E. , Ashrani, Aneel A. , Diep, Robert , Fogerty, Annemarie E., Gallastegui, Nicolas , Gangaraju, Radhika , Rojas‐Hernandez, Cristhiam M. , Goldhaber, Samuel Z. , Kubal, Timothy, Leavitt, Andrew D., Mann, Janelle , Mantha, Simon , Morton, Colleen , Nester, Alex, O’Brien, Andrew , Ranade, M. , Salmasi, Amirali , Schaefer, Jordan K. , Williams, Eliot C., Wun, Theodore, Nguyen, Jamie , Freedman-Cass, Deborah A., Sliker, Bailee , Ashrani, Aneel, Schaefer, Jordan K , Buckner, Tyler W. , Fertrin, Kleber Yotsumoto , Ibrahim, Ibrahim , Leavitt, Andrew D. , Lim, Ming Y , Mann, Janelle, O’Brien, Andrew, Ortel, Thomas L. , Pine, Alexander B. , Pishko, Allyson M. , Wool, Geoffrey D. , Montgomery, Sarah E.
Journal of the National Comprehensive Cancer Network | September 5, 2024 | Volume: 22 | Issue: 7 | Pages: 483-506
The NCCN Guidelines for Cancer-Associated Venous Thromboembolic Disease provide strategies for the prevention, diagnosis, and treatment of venous thromboembolism (VTE) in adult patients with cancer. VTE is a common and life-threatening condition in patients with cancer, and its management often requires multidisciplinary efforts. The NCCN panel is comprised of specialists spanning various fields, including cardiology, hematology, medical oncology, internal medicine, interventional radiology, and pharmacology. The content featured in this issue specifically addresses the evaluation and recommended treatment options outlined in the NCCN Guidelines for the diverse subtypes of cancer-associated VTE.