Pembrolizumab-induced severe rejection and graft intolerance syndrome resulting in renal allograft nephrectomy.
Sandeep Anand PadalaShivam K PatelAnusha VakitiNikhil PatelImran GaniRajan KapoorSaeed MuhammadPublished in: Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners (2020)
As emphasized in our case, there is a very high risk of graft rejection in patients who need to be placed on immunomodulators such as pembrolizumab, so the risk versus benefit needs to be assessed and discussed. Our case is unique because pembrolizumab not only caused graft rejection but also severe graft intolerance syndrome which led to transplant nephrectomy. Further guidelines are needed in renal transplant patients requiring PD-1 inhibitors to establish the ideal treatment plan of immunosuppression management and anti-cancer treatments.
Keyphrases
- end stage renal disease
- advanced non small cell lung cancer
- early onset
- ejection fraction
- chronic kidney disease
- robot assisted
- case report
- drug induced
- peritoneal dialysis
- diabetic rats
- clinical practice
- high glucose
- editorial comment
- patient reported outcomes
- combination therapy
- endothelial cells
- oxidative stress
- smoking cessation