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Case report
Pembrolizumab-associated autoimmune haemolytic anaemia
  1. Philippa Johnstone1 and
  2. Omar Khan2
  1. 1Oncology, Royal Berkshire Hospital, Reading, UK
  2. 2Oncology, Great Western Hospitals NHS Foundation Trust, Swindon, UK
  1. Correspondence to Dr Philippa Johnstone; philippa.johnstone1{at}nhs.net

Abstract

Treatment paradigms have recently changed with the introduction of immunotherapy; autoimmune toxicities that can arise are frequently very different from the more familiar chemotherapy toxicities. We present a clinical case of autoimmune haemolytic anaemia (AIHA) secondary to pembrolizumab occurring in a 73-year-old male patient being treated for lung adenocarcinoma, who had received 13 cycles of pembrolizumab. Treatment was immediately stopped and he was treated with high dose steroids to which he responded both clinically and biochemically. There have been prior reports of immunotherapy-associated AIHA with the use of cytotoxic T-lymphocyte-associated antigen-4 inhibitors, such as ipilimumab, but very few reports of programmed death-1 (PD-1)/programmed death-ligand 1 (PDL-1) inhibitor associated AIHA. We highlight a rare case of AIHA as an adverse effect of pembrolizumab, a PD-1 inhibitor. Although unusual, it is important to be vigilant for haematological immune-related adverse events.

  • oncology
  • lung cancer (oncology)

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Footnotes

  • Contributors PJ (main author) performed the literature review, interpreted the data and was the main author for writing up the case report, made substantial contributions to the case report, involved in revising the case report critically and re-drafting the content, approved final version to be published and is in agreement to be accountable for all aspects of the work OK. OK, the second author and consultant with overall responsibility for the patient’s clinical care involved in planning the piece of work, made substantial contributions to the case report, involved in critically revising the case report and re-drafting the content, approved final version to be published and is in agreement to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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