The American Society of Clinical Oncology (ASCO) has reviewed complications associated with immune checkpoint inhibitor therapy.
Patient selection: thrombotic thrombocytopenia purpura (TTP) or hemolytic uremia (HUS) following therapy with an immune checkpoint inhibitor
Parameters:
(1) RBC destruction with schistocytes
(2) renal insufficiency
(3) thrombocytopenia
(4) clinical status
|
RBC Destruction
|
Renal Insufficiency
|
Thrombocyto-penia
|
Clinical Status
|
Grade TTP
|
|
present
|
no
|
no
|
no change
|
G1
|
|
present with G2 anemia
|
no
|
yes
|
no change
|
G2
|
|
present with G3 anemia
|
yes
|
G3
|
present
|
G3
|
|
present
|
yes
|
G3 or G4
|
life-threatening
|
G4
|
|
RBC Destruction
|
Renal Insufficiency
|
Thrombocyto-penia
|
Clinical Status
|
Grade HUS
|
|
present
|
no
|
G2
|
no change
|
G1
|
|
present
|
no
|
G2
|
no change
|
G2
|
|
present
|
yes
|
G3 or G4
|
petechiae
|
G3
|
|
present
|
yes
|
G3 or G4
|
life-threatening
|
G4
|
The diagnosis requires exclusion of other diagnoses that can cause TTP or HUS.
