Table 2.
Characteristics of ICI-related cytopenias.
| All N = 75 |
ITP N = 38 |
AIHA N = 19 |
AIN N = 10 † |
PRCA N = 6 |
AA N = 2 |
|||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ICI | ||||||||||||
| Anti-PD-1 | 60 | (80.0) | 32 | (84.2) | 13 | (68.4) | 9 | (90.0) | 5 | (83.7) | 1 | (50.0) |
| Anti-PD-L1 | 6 | (8.0) | 4 | (10.5) | 2 | (10.5) | 0 | - | 0 | - | 0 | - |
| Anti-CTLA-4 | 2 | (2.7) | 1 | (2.6) | 1 | (5.2) | 0 | - | 0 | 0 | - | |
| Anti-PD-1 + anti-CTLA-4 | 7 | (9.3) | 1 | (2.6) | 3 | (15.8) | 1 | (10.0) | 1 | (16.7) | 1 | (50.0) |
| Time to immune-related cytopenia, months, median (IQR) | 2.0 | (1.0–4.5) | 1.8 | (1.0–4.8) | 1.4 | (1.0–2.8) | 2.4 | (1.2–4.5) | 2.1 | (1.4–2.8) | 4.7 | NA |
| Time to immune-related cytopenia, treatment cycles, median (IQR) | 3.0 | (2.0–6.0) | 3 | (1.0–5.0) | 2.0 | (1.0–4.0) | 3.5 | (2.0–6.0) | 3.0 | (2.0–7.0) | 7.0 | NA |
| Maximum severity (n = 74) | ||||||||||||
| Grade 2 | 9/74 | (12.2) | 3/38 | (7.9) | 6/18 | (33.3) | 0/10 | - | 0/6 | - | 0/2 | - |
| Grade 3 | 29/74 | (39.2) | 9/38 | (23.6) | 9/18 | (50.0) | 5/10 | (50.0) | 5/6 | (83.3) | 0/2 | - |
| Grade 4 | 33/74 | (44.6) | 24/38 | (63.2) | 2/18 | (11.1) | 5/10 | (50.0) | 1/6 | (16.7) | 2/2 | (100) |
| Grade 5 | 3/74 | (4.0) | 2/38 | (5.3) | 1/18 | (5.6) | 0/10 | - | 0/6 | - | 0/2 | - |
| Treatment of immune-related cytopenia (n = 72) | ||||||||||||
| Number of lines, median (IQR) | 1.0 | (1.0–1.0) | 1.0 | (1.0–1.0) | 1.0 | (1.0–1.0) | 1.0 | (1.0–1.0) | 1.5 | (1.0–2.0) | 1.0 | (1.0–1.0) |
| Glucocorticoids, | 56/72 | (77.8) | 32/36 | (88.9) | 16/19 | (84.2) | 2/10 | (20.0) | 5/5 | (100.0) | 1/2 | (50.0) |
| Intravenous immunoglobulins | 12/72 | (16.7) | 9/36 | (25.0) | 0/19 | - | 1/10 | (10.0) | 2/5 | (40.0) | 0/2 | - |
| G-CSF | 5/72 | (6.9) | 0/36 | - | 0/19 | - | 5/10 | (50.0) | 0/5 | - | 0/2 | - |
| Thrombopoietin agonist | 3/72 | (4.2) | 2/36 | (5.6) | 0/19 | - | 0/10 | - | 0/5 | - | 1/2 | (50.0) |
| Cyclosporine | 3/72 | (4.2) | 0/36 | - | 1/19 | (5.3) | 0/10 | - | 1/5 | (20.0) | 1/2 | (50.0) |
| ESA | 2/72 | (2.8) | 0/36 | - | 0/19 | - | 0/10 | - | 2/5 | (40.0) | 0/2 | - |
| Rituximab | 2/72 | (2.8) | 0/36 | - | 2/19 | (10.5) | 0/10 | - | 0/5 | - | 0/2 | - |
| Cyclophosphamide | 1/72 | (1.4) | 0/36 | - | 0/19 | - | 0/10 | - | 1/5 | (20.0) | 0/2 | - |
| Treatment response of immune-related cytopenia (n = 61) | ||||||||||||
| Complete | 30 | (49.2) | 16/32 | (50.0) | 6/14 | (42.9) | 7/9 | (77.8) | 1/5 | (20.0) | 0/2 | - |
| Partial | 14 | (23.0) | 8/32 | (25.0) | 4/14 | (28.6) | 0/9 | - | 1/5 | (20.0) | 1/2 | (50.0) |
| Stable disease | 17 | (27.9) | 8/32 | (25.0) | 4/14 | (28.6) | 2/9 | (22.2) | 3/5 | (60.0) | 0/2 | - |
| ICI resumption | 10 | (13.3) | 5 | (13.2) | 2 | (10.5) | 3 | (30.0) | 0 | - | 0 | - |
| Relapse of immune cytopenia after ICI resumption | 3 | (33.3) | 2 | (40.0) | 0 | - | 1 | (33.3) | 0 | - | 0 | - |
Data are expressed as n (%) unless otherwise stated. † 2 AINs were not treated. AA: Aplastic anemia, AIHA: Autoimmune hemolytic anemia, AIN: Autoimmune neutropenia, CTLA-4: Cytotoxic T-lymphocyte antigen-4, ESA: Erythropoiesis stimulating agent, G-CSF: Granulocyte Colony Stimulating Factor, ICI: Immune checkpoint inhibitor, IQR: Interquartile range, ITP: Immune thrombocytopenia purpura, PD-1: Programmed cell death 1, PD-L1: Programmed cell death ligand 1, PRCA: Pure red cell aplasia.