Misawa Kazuhito, Nakamichi Shinji, Iida Hiroki, Nagano Atsuhiro, Mikami Erika, Tozuka Takehiro, Matsumoto Masaru, Miyanaga Akihiko, Noro Rintaro, Kubota Kaoru, Yamaguchi Hiroki, Seike Masahiro
Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, 113-8603, Japan.
Department of Hematology, Nippon Medical School, Tokyo, 113-8603, Japan.
Onco Targets Ther. 2023 Jan 24;16:65-69. doi: 10.2147/OTT.S398375. eCollection 2023.
Alectinib is a selective anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitor as standard therapy for ALK-rearranged non-small cell lung cancer (NSCLC). Hemolytic anemia is considered as a rare but significant adverse event with alectinib. Here, we report a case of a 73-year-old female with lung adenocarcinoma, harbouring an ALK fusion gene, who received alectinib as second-line therapy and developed gradually progressive grade 4 (6.4 g/dL) drug-induced hemolytic anemia (DIHA) after complete response. We discontinued alectinib and performed a blood transfusion for the severe anemia. The anemia improved with no recurrence of lung adenocarcinoma over 10 months. Regular hematologic monitoring and the possibility of DIHA should be considered in case of progressive hemolytic anemia during alectinib treatment.
阿来替尼是一种选择性间变性淋巴瘤激酶（ALK）酪氨酸激酶抑制剂，作为ALK重排的非小细胞肺癌（NSCLC）的标准治疗药物。溶血性贫血被认为是阿来替尼一种罕见但严重的不良事件。在此，我们报告一例73岁患有肺腺癌且携带ALK融合基因的女性患者，该患者接受阿来替尼作为二线治疗，在完全缓解后逐渐发展为4级（6.4 g/dL）药物性溶血性贫血（DIHA）。我们停用了阿来替尼，并对严重贫血进行了输血治疗。贫血情况得到改善，在10个月内肺腺癌未复发。在阿来替尼治疗期间，如果出现进行性溶血性贫血，应考虑定期进行血液学监测以及DIHA的可能性。
