Haematological immune-related adverse events with immune checkpoint inhibitors, how to manage?

Immune checkpoint inhibitors (ICIs) are changing the treatments of many patients with cancer. These immunotherapies are generally better tolerated than chemotherapy, and their adverse events are immune-related mimicking autoimmune or inflammatory conditions. Although these immune-related adverse events mainly affect the skin, endocrine glands, digestive tract, joints, liver or lungs, all the organs can be theoretically affected, and the haematopoietic system is not spared. This review of the literature will focus on the haematological immune-related adverse events (Haem-irAEs). By reviewing the largest clinical trials of ICIs, we estimate the frequency of Haem-irAEs at 3.6% for all grades and 0.7% for grades III–IV. Frequency of Haem-irAEs of all grades was found to be higher with anti–programmed cell death 1 (4.1%) or anti–programmed cell death ligand 1 (4.7%) than with anti–cytotoxic T-lymphocyte–associated protein 4 (0.5%) (p