Severe immune thrombocytopenia following COVID-19 vaccination (Moderna) and immune checkpoint inhibitor - 14/05/22

Doi : 10.1016/j.ajem.2022.03.030

Kah-Meng Chong, MD ^a, Ching-Yao Yang, MD ^b, Chien-Chin Lin, MD ^c,^d,^e, Wan-Ching Lien, MD, PhD ^a,^{^⁎}
^a Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
^b Division of Pulmonology, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
^c Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
^d Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
^e Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan

^⁎Corresponding author at: Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. Add: No.7, ZhongShan South Road, ZhongZheng District, Taipei City 100, Taiwan.Department of Emergency Medicine, National Taiwan University HospitalNational Taiwan University College of Medicine, Taipei, TaiwanAdd: No.7, ZhongShan South Road, ZhongZheng DistrictTaipei City100Taiwan

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Abstract

Safe and effective prophylactic vaccines are urgently needed to contain the coronavirus disease 2019 (COVID-19) pandemic. However, several vaccination-related adverse effects have been reported. Here, we report a rare case of severe immune thrombocytopenia occurring 3 days after receiving the mRNA-1273 (Moderna) COVID-19 vaccine in an Asian woman with a history of refractory lung adenocarcinoma treated with durvalumab, an immune checkpoint inhibitor. Treatment with platelet transfusion (12 units) and oral prednisolone (1 mg/kg per day) significantly improved her hemoptysis with thrombocytopenia. To the best of our knowledge, this is the first case of ITP following Moderna inoculation among Asians. This study highlights a potential adverse effect of mRNA-based COVID-19 vaccines in cancer patients receiving immune checkpoint inhibitors.

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Keywords : COVID-19, Moderna vaccine, mRNA-based vaccine, Immune thrombocytopenia, Immune checkpoint inhibitors

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Vol 56

P. 395.e1-395.e3 - juin 2022 Retour au numéro

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Severe immune thrombocytopenia following COVID-19 vaccination (Moderna) and immune checkpoint inhibitor - 14/05/22

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