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Combination Intravenous Immune Globulin (IVIG) and High Dose Steroids for Treatment of Immune-Related Myelitis in a Non-Small Cell Lung Cancer Patient Treated With Pembrolizumab and Palliative Radiation Treatment: A Case Report

  • Timothy Owen
    Affiliations
    Cancer Centre of Southeastern Ontario, Kingston, Ontario, Canada

    Division of Radiation Oncology, Department of Oncology, Queen's University, Kingston, Ontario, Canada
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  • Andrea S. Fung
    Correspondence
    Address for correspondence: Andrea Fung, MD, PhD, Medical Oncologist, Cancer Centre of Southeastern Ontario, Queen's University, Kingston, Ontario, Canada, K7L 5P9
    Affiliations
    Cancer Centre of Southeastern Ontario, Kingston, Ontario, Canada

    Division of Medical Oncology, Department of Oncology, Queen's University, Kingston, Ontario, Canada
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Published:August 28, 2022DOI:https://doi.org/10.1016/j.cllc.2022.08.012

      Clinical Practice Points

      • Immune checkpoint inhibitor (ICI)-related myelitis is rare.
      • Majority of patients have persistent neurologic deficits despite first-line glucocorticoids suggesting that more aggressive immunosuppression (i.e. addition of another immunosuppressive agent to steroids) upfront might be warranted.
      • The current case report suggests that the combination of high dose steroids and IVIG might be a good combination for initial treatment of ICI-associated myelitis.
      • The interaction between radiation therapy and development of immune-related myelitis warrants further study.

      Keywords

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