Rare side effect caused by atezolizumab, an immune checkpoint inhibitor: Cold agglutinin disease

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dc.authorid0000-0003-2715-4002
dc.authorid0000-0003-1782-7808
dc.authorid0000-0001-8914-7911
dc.contributor.authorAçıkgöz, Özgür
dc.contributor.authorBayramgil, Ayberk
dc.contributor.authorÇavuşoğlu, Güneş
dc.contributor.authorSadri, Sevil
dc.date.accessioned2023-03-07T10:51:35Z
dc.date.available2023-03-07T10:51:35Z
dc.date.issued2021
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
dc.description.abstractIntroduction Immune checkpoint inhibitors are drugs that are included in the guidelines of hematological and solid cancer treatments, give highly effective results and increase T cell functionality. However, these drugs can cause immune-related adverse events resembling autoimmune diseases. Case report A 50-year-old male patient was admitted to an external center with complaints of chest pain and dyspnea. Thoracic CT revealed a 97 x 58 mm mass in the left lung, and a diagnosis of Small Cell Lung Cancer (SCLC) was made by biopsy. The PET/CT performed for staging was also evaluated as extensive stage small cell lung cancer. It was decided to give a combination of atezolizumab and carboplatin-etoposide to the patient. Management and outcome: The patient completed 3 cycles without any problem. Discordance was detected in the hemogram of the patient who came to the control for the assessment of response and had a regression in the imaging. Hemoglobin 9.6 g/dl (N: 14-17.5) hematocrit 14.8% (N: 41-51) were detected in the hemogram. Agglutinins were seen in the peripheral smear performed. Cold agglutinin (+4 positive) and indirect coombs (+3 positive) were found positive. Atezolizumab was stopped and methylprednisolone was started. After 10 days of treatment, discordance improved and methylprednisolone was discontinued by decreasing to half dose every 5 days. Discussion With the increasing use of immune checkpoint inhibitors, the variety of side effects has increased and case reports have increased. After detection of cold agglutinin, IgG, cryoglobulin, mycoplasma pneumonia, hepatitis B, hepatitis C and HIV were found negative in the differential diagnosis, Our case appears to be immune checkpoint inhibitor-related Cold Agglutinin Disease (CAD). It should not be forgotten that immune checkpoint inhibitors, which are widely used, may cause CAD, and hemoglobin-hematocrit discordance should be paid attention to in routine controls.
dc.identifier.citationAçıkgöz, Ö., Bayramgil, A., Çavuşoğlu, G. ve Sadri, S. (2021). Rare side effect caused by atezolizumab, an immune checkpoint inhibitor: Cold agglutinin disease. Journal of Oncology Pharmacy Practice, 27(8), 2066-2068. https://dx.doi.org/10.1177/10781552211033009
dc.identifier.doi10.1177/10781552211033009
dc.identifier.endpage2068
dc.identifier.issn1078-1552
dc.identifier.issn1477-092X
dc.identifier.issue8
dc.identifier.pmid34282980
dc.identifier.scopus2-s2.0-85111255109
dc.identifier.scopusqualityQ3
dc.identifier.startpage2066
dc.identifier.urihttps://dx.doi.org/10.1177/10781552211033009
dc.identifier.urihttps://hdl.handle.net/20.500.12511/10577
dc.identifier.volume27
dc.identifier.wos000676838300001en_US
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorAçıkgöz, Özgür
dc.institutionauthorBayramgil, Ayberk
dc.institutionauthorÇavuşoğlu, Güneş
dc.institutionauthorSadri, Sevil
dc.language.isoen
dc.publisherSAGE Publications Ltd
dc.relation.ispartofJournal of Oncology Pharmacy Practiceen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectAtezolizumab
dc.subjectCold Agglutinin
dc.subjectMethylprednisolone
dc.titleRare side effect caused by atezolizumab, an immune checkpoint inhibitor: Cold agglutinin disease
dc.typeArticle

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