So my father (77y/o) has been diagnosed with Stage 4 metastatic melanoma in May 2015. He had the primary removed in 2006 with a tumor depth of 0.6mm and it turned out to be amelanotic malign melanoma (it was a red suspicious mole). Follow-Up Checks didn't show anything for the next years.
Until April 2015. He had very bad pain in his back which first wasn't anything it made us worry because he always had problems with his spine (had a discogenic surgery 30 years ago). But this time the pain didn't go away so he went to the hospital in May 2015 where it turned out that his cervical spine was badly damaged due to tumor activity. He had to undergo surgery to stabilize the spine and a biopsy was made. Result was the tumors were mets from the melanoma. Scans showed he had multiple mets in his spine, hip bones, shoulder bones and "little ones" in his lungs which they couldn't tell if they were really mets or just granulomas. So Stage 4.
He is B-RAF positive so he started a Therapy with Zelboraf in late June 2015 plus radioation of his spine mets in order to stabilize it. After 2 Weeks on 4-0-4 he had to go to the hospital because of a sudden very bad rash. Zelboraf was paused for one week then he started again with a reduced dosis 2-0-2. Side Effects were manageable but the sun sensivity and fatigue were really challenging, especially because we here in germany had an extreme heat wave from june to september. In End of August suddenly a lot of small black points started growing on his head (skin) which were tested and were diagnosed as mets. CT-Scans in September shows that his mets grew under zelboraf and new mets showed up in the liver and maybe in the pankreas :-(.
Zelboraf was stopped immediately and one week later he got his first dose of Opdivo (Nivolumab) at 3mg/kg every 2 weeks. One Day after his first Infusion he was rushed to the hospital because his heart beat rate went lower than 40. It seems that it wasn't because of the infusion but due to atrial fibrillation (he has this since 15 years which is treated with beta-blockers and blood thinners). He was able to go home after 2 Days and his Nivolumab-Therapy will continue since it seems it had nothing to do with it.
Next Thursday he should get his 2nd dose of Nivolumab but it was now delayed because his blood tests showed he has too low leukocytes so he gets a infusion first to build them up and after that, when blood is ok again he will get his 2nd infusion.
Is this a common side effect? I know that leukocytes often are low on traditional chemotherapy but i haven't heard of it with immunotherapy.
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