Between 1% and 10% developed cold sores, pain or infection in the lesion, anemia, immune mediated events (like vasculitis, pneumonia, worsening psoriasis, glomerulonephritis and vitiligo ), dehydration, confusion, anxiety, depression, dizziness, insomnia, ear pain, fast heart beating, deep vein thrombosis, high blood pressure, flushing, shortness of breath when exercising, sore throat, symptoms of the common cold, stomach pain, back pain, groin pain, weight loss, or oozing from the injection site. Pharmacology
Talimogene laherparepvec is taken up by normal cells and cancer cells like the wild type herpes simplex virus, it is cleared in the same way. Mechanism
Talimogene laherparepvec directly destroys the cancer cells it infects, inducing a systemic immune response against the patients cancer.The virus invades both cancerous and healthy cells, but it cannot productively replicate in healthy tissue because it lacks Infected cell protein 34.5 (ICP34.5). When cells are infected with a virus they shut down and die, but ICP34.5 blocks this stress response, allowing the virus to hijack the cells translation machinery to replicate itself. A herpesvirus lacking the gene coding for ICP34.5 cannot replicate in normal tissue. However, in many cancer cells the stress response is already disrupted, so a virus lacking ICP34.5 can still replicate in tumors. After the virus has replicated many times, the cell swells and finally bursts, killing the cell and releasing the copies of the virus, which can then infect nearby cells.While talimogene laherparepvec is using the cells translation machinery to replicate, it also uses it to make the cell create GM-CSF.
Thymus hyperplasia refers to an enlargement ("hyperplasia") of the thymus.It is not always a disease state. The size of the thymus usually peaks during adolescence and atrophies in the following decades. Before the immune function of the thymus was well understood, the enlargement was sometimes seen as a cause for alarm, and justification for surgical reduction. This approach is much less common today. It can be associated with myasthenia gravis. Magnetic Resonance Imaging can be used to distinguish it from thymoma. Thymic hyperplasia
Thymic hyperplasia can be divided into three groups namely, those without any pre-existing medical condition, those recovering from a pre-existing medical condition such as pneumonia, corticosteroid therapy, radiation therapy, chemotherapy, surgery, and burns, and those with other disorders such as  hyperthyroidism, sarcoidosis, or pure red cell aplasia. References


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