PDF(Pubmed)
Abstract：
UNASSIGNED: Combination therapy of atezolizumab and chemotherapy has become the standard treatment for small-cell lung cancer. Immune-related adverse events (irAEs) can occur during immune checkpoint inhibitor administration. A few reports exist on pure red cell aplasia (PRCA) as an irAE after atezolizumab treatment. PRCA is characterized by normocytic-normochromic anemia, a marked decrease in reticulocytes, and a decrease in bone marrow erythroblasts. Here, we report a case of atezolizumab-induced PRCA.
UNASSIGNED: A 69-year-old male patient was brought to the emergency department with the chief complaint of seizures. Multiple metastatic brain tumors and a mass suspected to be the primary lesion in the right hilar region were observed. After a brain biopsy, he was diagnosed with small-cell lung cancer (cT1cN0M1c stage IVB). He received four courses of carboplatin, etoposide, and atezolizumab in combination with whole-brain irradiation, which led to a partial response. After six courses of atezolizumab maintenance therapy, severe anemia (hemoglobin, 3.4 g/dL) was observed. PRCA induced by atezolizumab was diagnosed using a bone marrow biopsy performed during red blood cell transfusion. Treatment was started with prednisolone 25 mg/day (0.5 mg/kg/day). Anemia improved, and the dose was gradually reduced to 5 mg/day.
UNASSIGNED: Reports of PRCA as an irAE are rare but important; hence, we reported this case.
UNASSIGNED: A 69-year-old male patient was brought to the emergency department with the chief complaint of seizures. Multiple metastatic brain tumors and a mass suspected to be the primary lesion in the right hilar region were observed. After a brain biopsy, he was diagnosed with small-cell lung cancer (cT1cN0M1c stage IVB). He received four courses of carboplatin, etoposide, and atezolizumab in combination with whole-brain irradiation, which led to a partial response. After six courses of atezolizumab maintenance therapy, severe anemia (hemoglobin, 3.4 g/dL) was observed. PRCA induced by atezolizumab was diagnosed using a bone marrow biopsy performed during red blood cell transfusion. Treatment was started with prednisolone 25 mg/day (0.5 mg/kg/day). Anemia improved, and the dose was gradually reduced to 5 mg/day.
UNASSIGNED: Reports of PRCA as an irAE are rare but important; hence, we reported this case.
摘要：
■阿特珠单抗和化疗的联合治疗已成为小细胞肺癌的标准治疗方法。在免疫检查点抑制剂施用期间可能发生免疫相关不良事件(irAE)。阿特珠单抗治疗后，纯红细胞再生障碍（PRCA）作为irAE存在一些报道。PRCA的特征是正常细胞-正常色素性贫血，网织红细胞明显减少,骨髓成红细胞减少.这里,我们报告一例阿替珠单抗诱导的PRCA.
■一名69岁的男性患者被带到急诊科，主诉为癫痫发作。观察到多发性转移性脑肿瘤和怀疑是右肺门区域的原发病灶。脑活检后,他被诊断为小细胞肺癌（cT1cN0M1c阶段IVB）。他接受了四个疗程的卡铂,依托泊苷,阿替珠单抗联合全脑照射，这导致了部分反应。经过六个疗程的阿替珠单抗维持治疗，严重贫血（血红蛋白，观察到3.4g/dL)。使用红细胞输注期间进行的骨髓活检诊断由阿特珠单抗诱导的PRCA。用泼尼松龙25mg/天(0.5mg/kg/天)开始治疗。贫血好转,剂量逐渐减少至5mg/天。
■PRCA作为irAE的报告很少见，但很重要；因此，我们报告了这个病例。
■一名69岁的男性患者被带到急诊科，主诉为癫痫发作。观察到多发性转移性脑肿瘤和怀疑是右肺门区域的原发病灶。脑活检后,他被诊断为小细胞肺癌（cT1cN0M1c阶段IVB）。他接受了四个疗程的卡铂,依托泊苷,阿替珠单抗联合全脑照射，这导致了部分反应。经过六个疗程的阿替珠单抗维持治疗，严重贫血（血红蛋白，观察到3.4g/dL)。使用红细胞输注期间进行的骨髓活检诊断由阿特珠单抗诱导的PRCA。用泼尼松龙25mg/天(0.5mg/kg/天)开始治疗。贫血好转,剂量逐渐减少至5mg/天。
■PRCA作为irAE的报告很少见，但很重要；因此，我们报告了这个病例。
