Иммунотерапия ниволумабом улучшила состояние пациента с терапий-ассоциированным миелодиспластическим синдромом

Treatment with nivolumab for metastatic melanoma may have improved a concurrent case of therapy-related myelodysplastic syndrome (MDS) in a case report published in Current Oncology. The 67-year-old man in the case developed therapy-related MDS and profound pancytopenia following treatment for oligosecretory multiple myeloma that included chemotherapy, radiotherapy, and ultimately autologous stem cell transplantation. His therapy-related MDS required frequent platelet and packed red blood cell transfusions. A few months later, the patient developed metastatic melanoma, which spread to his bones, liver, lungs, and lymph nodes. To treat the newly developed metastatic melanoma, the patient began receiving nivolumab every 2 weeks, which subsequently led to improvements in platelet (from 48 to 68 × 109/L), hemoglobin (from 65 to 108 g/L), and white blood cell counts (from 1.61 to 3.15 × 109/L). Roughly 2 weeks after starting nivolumab, the patient received his last blood transfusion and remained transfusion-independent for the rest of the observation period. “Nivolumab is a programmed cell death protein-1 (PD-1) immune checkpoint inhibitor widely used in the treatment of metastatic melanoma and other advanced malignancies,” the authors said. “However, its effects on therapy-related MDS remain poorly understood.” Within 2 months of treatment, the patient reported an Edmonton Symptom Assessment System (ESAS) score of 0, indicating a complete resolution of symptom burden. By 6 months of nivolumab treatment, the patient had also experienced significant clinical improvements, including stabilized serum markers (complete blood count, renal, thyroid, and hepatic function) and improved quality of life. The patient’s hematologic parameters remained stable through the last follow-up appointment in May 2026. He continued to be transfusion-independent but remained on palliative nivolumab to sustain the radiographic stability of the metastatic melanoma. However, without a bone marrow biopsy, MDS remission could not be confirmed. As the authors relate it, “the response described in this report reflects durable hematologic recovery rather than morphologically confirmed remission.” They express that while the results of a single case report do not indicate a causal relationship between the resolution of therapy-related MDS symptoms and treatment with nivolumab, the durable response is notable and supports further investigation of nivolumab in selected patients with therapy-related MDS. This article originally appeared on Rare Disease Advisor References: Hamza FNM, Eltayeb F, Al Katari M, Ibrahim MFK. Durable hematologic response in therapy-related myelodysplastic syndrome during nivolumab treatment for metastatic melanoma: a case report. Curr Oncol. Published online August 12, 2026. doi:10.3390/curroncol33080476