[Acquired thrombotic thrombocytopenic purpura during durvalumab monotherapy for non-small cell lung cancer]

Rinsho Ketsueki. 2024;65(1):24-29. doi: 10.11406/rinketsu.65.24.
[Article in Japanese]


Immune checkpoint inhibitor (ICI)-induced thrombocytopenias are rare immune-related adverse events (irAE), but ICI-related thrombotic thrombocytopenic purpura (TTP) is extremely rare. A 79-year-old woman with non-small cell lung cancer received maintenance therapy with the anti-human PD-L1 monoclonal antibody durvalumab. Four weeks after the last infusion, she developed overt TTP. Remission was achieved by plasma exchange and prednisolone, and the patient has now been recurrence-free for over 12 months. To our knowledge, this is the first report of TTP occurring as an irAE of durvalumab.

Keywords: Durvalumab; Thrombotic thrombocytopenic purpura; irAE.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Aged
  • Antibodies, Monoclonal / adverse effects
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Carcinoma, Non-Small-Cell Lung* / etiology
  • Female
  • Humans
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / etiology
  • Plasma Exchange / adverse effects
  • Purpura, Thrombotic Thrombocytopenic* / chemically induced
  • Purpura, Thrombotic Thrombocytopenic* / diagnosis
  • Purpura, Thrombotic Thrombocytopenic* / therapy


  • durvalumab
  • Antibodies, Monoclonal

Supplementary concepts

  • Thrombotic thrombocytopenic purpura, acquired