Browse > Article
http://dx.doi.org/10.12701/yujm.2021.00899

Pembrolizumab-related autoimmune hemolytic anemia in a patient with metastatic lung adenocarcinoma: a case report  

Baek, Dong Won (Department of Hematology/Oncology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital)
Chae, Yee Soo (Department of Hematology/Oncology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital)
Publication Information
Journal of Yeungnam Medical Science / v.38, no.4, 2021 , pp. 366-370 More about this Journal
Abstract
Immune checkpoint inhibitors (ICIs) have become the main drugs for programmed cell death receptor-1 or ligand-1 expressing non-small cell lung cancer (NSCLC) combined with conventional chemotherapy. ICIs are generally more tolerable than cytotoxic chemotherapies in terms of toxicity, and ICI-related adverse events are mild and manageable. However, these drugs may lead to unexpected severe adverse events such as immune-related hematologic toxicities, which could be life-threatening. Here, a rare case of a pembrolizumab-related adverse event in a patient with NSCLC who showed early-onset hemolytic anemia and recovered by high-dose steroid and a series of plasma exchanges is reported.
Keywords
Autoimmune hemolytic anemia; Immune checkpoint inhibitors; Non-small-cell lung carcinoma; Pembrolizumab;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Mellman I, Coukos G, Dranoff G. Cancer immunotherapy comes of age. Nature 2011;480:480-9.   DOI
2 Michot JM, Bigenwald C, Champiat S, Collins M, Carbonnel F, Postel-Vinay S, et al. Immune-related adverse events with immune checkpoint blockade: a comprehensive review. Eur J Cancer 2016;54:139-48.   DOI
3 Weber JS, Hodi FS, Wolchok JD, Topalian SL, Schadendorf D, Larkin J, et al. Safety profile of nivolumab monotherapy: a pooled analysis of patients with advanced melanoma. J Clin Oncol 2017;35:785-92.   DOI
4 Gandhi L, Rodriguez-Abreu D, Gadgeel S, Esteban E, Felip E, De Angelis F, et al. Pembrolizumab plus chemotherapy in metastatic non-small-cell lung cancer. N Engl J Med 2018;378:2078-92.   DOI
5 Kong BY, Micklethwaite KP, Swaminathan S, Kefford RF, Carlino MS. Autoimmune hemolytic anemia induced by anti-PD-1 therapy in metastatic melanoma. Melanoma Res 2016;26:202-4.   DOI
6 Tanios GE, Doley PB, Munker R. Autoimmune hemolytic anemia associated with the use of immune checkpoint inhibitors for cancer: 68 cases from the Food and Drug Administration database and review. Eur J Haematol 2019;102:157-62.   DOI
7 Packman CH. The clinical pictures of autoimmune hemolytic anemia. Transfus Med Hemother 2015;42:317-24.   DOI
8 Ribas A. Tumor immunotherapy directed at PD-1. N Engl J Med 2012;366:2517-9.   DOI
9 Haanen JB, Carbonnel F, Robert C, Kerr KM, Peters S, Larkin J, et al. Management of toxicities from immunotherapy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2017;28(Suppl 4):IV119-42.   DOI
10 Nair R, Gheith S, Nair SG. Immunotherapy-associated hemoytic anemia with pure red-cell aplasia. N Engl J Med 2016;374:1096-7.   DOI
11 Mahoney KM, Freeman GJ, McDermott DF. The next immune-checkpoint inhibitors: PD-1/PD-L1 blockade in melanoma. Clin Ther 2015;37:764-82.   DOI
12 Dobosz P, Dzieciatkowski T. The intriguing history of cancer immunotherapy. Front Immunol 2019;10:2965.   DOI
13 Delanoy N, Michot JM, Comont T, Kramkimel N, Lazarovici J, Dupont R, et al. Haematological immune-related adverse events induced by anti-PD-1 or anti-PD-L1 immunotherapy: a descriptive observational study. Lancet Haematol 2019;6:e48-57.
14 Choi J, Lee SY. Clinical characteristics and treatment of immune-related adverse events of immune checkpoint inhibitors. Immune Netw 2020;20:e9.   DOI
15 Palla AR, Kennedy D, Mosharraf H, Doll D. Autoimmune hemolytic anemia as a complication of nivolumab therapy. Case Rep Oncol 2016;9:691-7.   DOI
16 Atiq O, Atiq SO, Atiq ZO, Patel V, Atiq MO, Atiq OT. Pembrolizumab-induced cold agglutinin disease. Am J Case Rep 2020;21:e924283.
17 Calvo R. Hematological side effects of immune checkpoint inhibitors: the example of immune-related thrombocytopenia. Front Pharmacol 2019;10:454.   DOI