Leukoencephalopathy is a rare complication of PD1 inhibitor therapy

Abstract

The indications for immunotherapy are expanding every year and the therapeutic algorithms for most types of solid tumors are steadily evolving towards the wider and earlier use of immune checkpoint inhibitors (ICI). However, everything has its price, and along with the treatment response, this class of drugs has brought a number of peculiar autoimmune complications associated with ICI and called immune-related adverse events (irAEs). Taking into account the peculiarities of the mechanism of action, the range of complications of this therapy is limited only by the list of structures and tissues of the human body. A special place is occupied by neurological adverse events due to their diversity, complexity of diagnosis requiring multidisciplinary approach, and relatively low prevalence.

The purpose of this work is to describe the peculiarities of the course and diagnosis of leukoencephalopathy on the background of skin melanoma treatment with the use of checkpoint inhibitors. A clinical case of a patient with melanoma IIC who developed retrograde amnesia and convulsive syndrome on the background of immunotherapy is presented. On the basis of clinical picture and examination data the diagnosis of «leukoencephalopathy» was established. Any organs and systems can be affected during the whole period of ICT treatment. Clinicians should keep in mind the possibility of leukoencephalopathy development after the start of this therapy.