Immune-related eosinophilia induced by anti-programmed death 1 or death-ligand 1 antibodies

Moderate-to-severe eosinophilia induced by treatment with immune checkpoint inhibitors: 37 cases from a national reference center for hypereosinophilic syndromes and the French pharmacovigilance database

“…7 Given our stringent inclusion criteria, our objective here was to describe the patients with the most severe ICI-induced AEs; according to Bernard-Teissier et al these patients may account for up to 1-2% of people treated with ICIs. 6 We found that a high proportion of these patients developed Eo-irAEs (57%)suggesting that although blood eosinophilia is highly unusual, 6 it should not be neglected by attending physicians because severe eosinophil-related organ dysfunction is likely to occur. In the present study, we chose to include patients (n = 7) with an AEC >0.5 G/L at baseline (i.e.…”

“…Moreover, this time to onset was shorter in our study than in Berrnard-Teissier et al's retrospective observational study of 26 cases with a normal AEC at baseline and an AEC >0.5G/L 3 [0.6─31.3] months after ICI initiation. 6 Although the time course of eosinophilia onset has yet to be characterized, one can reasonably hypothesize that moderate-to-severe eosinophilia may have an early onset. Similarly, the median time to the AEC peak observed in our study (3.4 Figure 1.…”

“…5 In a recent retrospective single-center study, the prevalence of immune-related blood eosinophilia (an absolute eosinophil count (AEC) greater than 0.5 G/L) in patients treated with anti-PD1 or anti-PD-L1 drugs was 2.8%, and the median [range] peak AEC was 1.0 [0.6─5.6] G/L. 6 Although druginduced eosinophilia (and thus, in theory, all other eosinophilic disorders) can be associated with eosinophil-induced organ damage, these cases of immune-related blood eosinophilia (Eo-ir) had a favorable outcome, and required neither specific treatment nor ICI discontinuation. 6 At the French national reference center for hypereosinophilic syndromes (CEREO), we were solicited for several patients with severe, well-documented, eosinophil-induced adverse events (Eo-irAEs) and organ dysfunction.…”

“…6 Although druginduced eosinophilia (and thus, in theory, all other eosinophilic disorders) can be associated with eosinophil-induced organ damage, these cases of immune-related blood eosinophilia (Eo-ir) had a favorable outcome, and required neither specific treatment nor ICI discontinuation. 6 At the French national reference center for hypereosinophilic syndromes (CEREO), we were solicited for several patients with severe, well-documented, eosinophil-induced adverse events (Eo-irAEs) and organ dysfunction. The objective of the present study was to describe the characteristics and outcomes of patients with moderate-to-severe eosinophilia (defined in this study as an AEC >1G/L) and/or Eo-irAEs reported in CEREO's database and the French national pharmacovigilance database (FPVD).…”

Clinical diagnosis and treatment recommendations for immune checkpoint inhibitor‐related hematological adverse events

“…Most of the hema‐AEs manifested as monolineage cytopenia, or bilineage cytopenia such as thrombocytopenia with neutropenia, and even pancytopenia such as aplastic anemia. Other rare AEs include acquired hemophilia A, eosinophilia, large granular lymphocytosis (LGL), even life‐threatening diseases such as hemophagocytic lymphohistiocytosis., This article aims to provide a comprehensive description of hematological irAEs in cancer patients treated with ICIs and suggest preliminary treatment recommendations.…”