Objective  To retrospectively explore the diagnosis and treatment of severe immune thrombocytopenia (SIT) induced by programmed death-1 (PD-1) monoclonal antibody.

Methods  Three patients with SIT caused by PD-1 monoclonal antibody treatment at Putuo District People's Hospital, Zhoushan City, Zhejiang Province from March 2020 to October 2022 were selected, and the diagnosis and treatment process and disease outcome were analyzed.

Results  All three patients were diagnosed with malignant tumors after postoperative pathological examination, and SIT was induced after PD-1 monoclonal antibody treatment, of which one patient died, and two patients improved after the treatment.

Conclusion  PD-1 induced SIT often occurs after 12 weeks, and clinical diagnosis can be confirmed by combining patients’ medication history, platelet antibodies, and bone marrow examination. In terms of treatment, combination therapy such as ordered reduction of hormones, thrombopoietin, and platelet receptor agonists can promote the recovery of the patient. In addition, if necessary, CD20 monoclonal antibody therapy can be applied to antagonize platelet antibodies.

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