Objective:

To delineate clinical features and management strategies for significant myelosuppression following immune checkpoint inhibitor (ICI) and chemotherapy combination therapy in lung cancer patients, highlighting its clinical significance.

Key Findings:

• Both patients achieved full hematologic restoration with high-dose glucocorticoids and standard supportive care, underscoring the importance of glucocorticoid therapy.
• Significant myelosuppression post-ICI and chemotherapy is attributed to multiple factors, primarily chemotherapy, necessitating careful monitoring.
• Immediate glucocorticoid administration is crucial if ICI-associated toxicity is suspected, highlighting the need for prompt action.

Interpretation:

Healthcare providers should consider an immune-mediated mechanism in cases of myelosuppression following ICI and chemotherapy, and act promptly to manage potential complications, including specific management protocols.

Limitations:

• This study is based on a limited retrospective analysis, which may introduce biases.
• Further large-scale studies are needed to determine optimal glucocorticoid dosing and treatment duration, addressing potential confounding factors.

Conclusion:

Timely differential diagnosis and management strategies are essential for addressing severe myelosuppression in patients receiving ICI and chemotherapy, emphasizing the importance of early intervention.