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.
■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。