{
  "abstract": "Immune checkpoint inhibitors (ICIs) have significantly improved survival outcomes in patients with advanced malignancies. However, their association with immune thrombocytopenia (ITP) poses a critical risk of severe hemorrhage and necessitates treatment discontinuation. The precise molecular mechanisms underlying ICI-associated ITP remain largely unclear, critically impeding the development of predictive biomarkers and targeted therapeutic strategies. Here, we present a case report of an elderly patient with stage IV gastric adenocarcinoma who developed recurrent ITP following programmed death receptor-1 (PD-1) inhibitor serplulimab, trastuzumab and chemotherapy. Notably, longitudinal peripheral blood mononuclear cell samples were collected and subjected to transcriptomic profiling before and after two distinct ITP episodes: the initial occurrence and a recurrence triggered by PD-1 inhibitor rechallenge, providing matched time-resolved data for mechanistic analysis. Our findings demonstrate that ICIs-induced ITP involves a dual pathogenic mechanism combining immune-mediated platelet destruction and intrinsic megakaryopoietic impairment providing a novel conceptual framework for understanding this immunotherapy complication. And this represents the first prospective longitudinal investigation combining serial biospecimen collection with transcriptomic profiling (RNA sequencing) to elucidate mechanisms underlying ICIs-induced ITP.",
  "authors": [
    {
      "affiliations": [
        "Department of Medical Oncology, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China",
        "Cancer Center, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China"
      ],
      "name": "Huishan Li"
    },
    {
      "affiliations": [
        "Department of Medical Oncology, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China",
        "Cancer Center, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China"
      ],
      "name": "Yan Wang"
    },
    {
      "affiliations": [
        "Department of Laboratory Medicine, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China"
      ],
      "name": "Jianfeng Zhu"
    },
    {
      "affiliations": [
        "Department of Laboratory Medicine, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China"
      ],
      "name": "Hehui Chen"
    },
    {
      "affiliations": [
        "Department of Medical Oncology, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China",
        "Cancer Center, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China",
        "Department of Oncology, Zhongshan Hospital (Xiamen), Zhongshan Hospital Fudan University, Xiamen, Fujian, China",
        "Clinical Research Center for Precision Medicine of Abdominal Tumor of Fujian Province, Zhongshan Hospital Fudan University, Xiamen, Fujian, China"
      ],
      "name": "Tianshu Liu"
    },
    {
      "affiliations": [
        "Department of Medical Oncology, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China",
        "Cancer Center, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China"
      ],
      "name": "Luoyan Ai"
    }
  ],
  "title": "Mechanistic insights into PD-1 inhibitor-associated immune thrombocytopenia: a case report integrating longitudinal transcriptomic profiling",
  "uid": "4708a3ae-9b50-5bf3-b0de-76c4109ba834"
}