Severe complications of nivolumab
monotherapy in an adolescent
with malignant melanoma

Aleksandra Grzegorczyk; Zuzanna Marczyńska; Rafał Matkowski; Marcin Ziętek; Wojciech Pietras; Elżbieta Latos-Grażyńska; Krzysztof Kałwak; Iwona Dachowska-Kałwak

doi:10.5114/ceji.2023.130864

eISSN: 1644-4124
ISSN: 1426-3912

Central European Journal of Immunology

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3/2023
vol. 48

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abstract:

Case report

Severe complications of nivolumab monotherapy in an adolescent with malignant melanoma

Aleksandra Grzegorczyk

¹

,

Zuzanna Marczyńska

¹

,

Rafał Matkowski

^{2, 3}

,

Marcin Ziętek

^{2, 3}

,

Wojciech Pietras

¹

,

Elżbieta Latos-Grażyńska

¹

,

Krzysztof Kałwak

¹

,

Iwona Dachowska-Kałwak

¹

Department of Pediatric Stem Cell Transplantation, Hematology and Oncology, Wroclaw Medical University, Wrocław, Poland
Departament of Oncology, Wrocław Medical University, Wrocław, Poland
Lower Silesian Oncology, Pulmonology and Hematology Center, Wrocław, Poland

Cent Eur J Immunol 2023; 48 (3): 251-256

DOI: https://doi.org/10.5114/ceji.2023.130864

Online publish date: 2023/08/30

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This study presents a case of a 17-year-old female patient who had previously undergone surgical resection of melanoma in the right periscapular area. She was administered adjuvant treatment with the PD-1 inhibitor nivolumab as monotherapy. The mechanism of action of this drug is based on increased stimulation of the immune system. The patient developed a series of complications including capillary leak syndrome and hypothyroidism after the fifth cycle of therapy, as a result of dysregulation of immunity. Nivolumab treatment had to be discontinued and glucocorticosteroids were administered as a salvage therapy. After several months, two relapses developed in the subcutaneous tissue – first in the left and then in the right iliac region, confirmed as distant metastases of malignant melanoma, treated with resections of the lesions and intensity-modulated radiation therapy. Follow-up imaging studies and clinical examinations showed no metastases or pathologically enlarged lymph nodes.

keywords:

Severe complications of nivolumab monotherapy in an adolescent with malignant melanoma

Aleksandra Grzegorczyk 1 , Zuzanna Marczyńska 1 , Rafał Matkowski 2, 3 , Marcin Ziętek 2, 3 , Wojciech Pietras 1 , Elżbieta Latos-Grażyńska 1 , Krzysztof Kałwak 1 , Iwona Dachowska-Kałwak 1

melanoma, hypothyroidism, nivolumab, capillary leak syndrome

Aleksandra Grzegorczyk

¹

,

Zuzanna Marczyńska

¹

,

Rafał Matkowski

^{2, 3}

,

Marcin Ziętek

^{2, 3}

,

Wojciech Pietras

¹

,

Elżbieta Latos-Grażyńska

¹

,

Krzysztof Kałwak

¹

,

Iwona Dachowska-Kałwak

¹