Extensive stage small cell lung cancer with immune thrombocytopenic purpura: a case report
Mao Sasamotoa Tetsuya Sakaia Hajime Oia Takaya Ikedab Junichiro Yudac Koichi Gotoa
aDepartment of Thoracic Oncology, National Cancer Center Hospital East
bDepartment of Respiratory Medicine, National Hospital Organization Nagasaki Medical Center
cDepartment of Hematology, National Cancer Center Hospital East
The patient, a 55-year-old man, was treated with cisplatin, etoposide, and durvalumab combination chemotherapy as first line therapy for extensive stage small cell lung cancer (ES-SCLC). On the 35th day, thrombocytopenia of 9.7×104/μL was observed, and on the 50th day, platelets decreased to 5.6×104/μL. The diagnosis of immune thrombocytopenic purpura (ITP) was made based on the exclusion of other thrombocytopenic diseases, normal bone marrow findings, and elevated platelet associated immunoglobulin G. The patient was treated with high-dose dexamethasone, but only transient platelet elevation was observed, so romiplostim was administered. Thereafter, the platelet count increased and chemotherapy was possible. It is important to aggressively treat ITP that appears during treatment of ES-SCLC and to continue chemotherapy.
Small cell lung cancer (SCLC) Durvalumab Immune-related adverse event (irAE) Immune thrombocytopenic purpura (ITP) Romiplostim
Received 21 Aug 2022 / Accepted 3 Oct 2022
AJRS, 12(1): 44-49, 2023