Department of Respiratory Medicine, National Centre for Global Health and Medicine, Shinjuku-ku, Japan.
Thorac Cancer. 2020 Sep;11(9):2731-2735. doi: 10.1111/1759-7714.13582. Epub 2020 Aug 7.
Immune checkpoint inhibitors (ICIs) are reportedly effective against many kinds of neoplasm, but may be responsible for several kinds of immune-related adverse events (irAEs). Among these irAEs, the incidence of myelosuppression due to ICIs is relatively low. Corticosteroids are needed to control most cases of myelosuppression. Here, we report an 88-year-old woman with squamous cell lung cancer who was administered pembrolizumab. After five cycles of pembrolizumab, she developed severe pancytopenia. The pancytopenia improved under observation without steroid administration after cessation of pembrolizumab. During recovery from this irAE, the patient also maintained long-term antitumor efficacy. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: There are several kinds of immune-related adverse events. We encountered a case of pembrolizumab-induced pancytopenia with squamous cell lung cancer. WHAT THIS STUDY ADDS: Corticosteroids are needed to control most cases of myelosuppression induced by ICIs, but pancytopenia induced by pembrolizumab in our case improved without steroids.
免疫检查点抑制剂 (ICIs) 据报道对多种肿瘤有效，但可能导致几种免疫相关不良事件 (irAEs)。在这些 irAEs 中，由于 ICI 引起的骨髓抑制的发生率相对较低。大多数骨髓抑制病例需要用皮质类固醇治疗。在这里，我们报告了一例 88 岁女性患有鳞状细胞肺癌，给予了 pembrolizumab 治疗。在 pembrolizumab 治疗五个周期后，她出现严重的全血细胞减少症。在停止 pembrolizumab 后，无需类固醇治疗，全血细胞减少症得到改善。在从这种 irAE 中恢复期间，患者也保持了长期的抗肿瘤疗效。
存在多种免疫相关不良事件。我们遇到了一例鳞状细胞肺癌患者的 pembrolizumab 诱导的全血细胞减少症。
皮质类固醇是控制大多数由 ICI 引起的骨髓抑制的必需药物，但我们病例中的 pembrolizumab 诱导的全血细胞减少症在没有类固醇的情况下得到了改善。
