Department of Thoracic Oncology, Pleural Diseases, and Interventional Pulmonology, Hôpital Nord, Aix-Marseille University, 13015 Marseille, France.
Faculty La Timone, Aix-Marseille University, 13005 Marseille, France.
Curr Oncol. 2024 Apr 17;31(4):2274-2277. doi: 10.3390/curroncol31040168.
Maintenance chemotherapy is a standard treatment in patients with non-progressive advance staged IV non-squamous non-small cell lung cancer after induction therapy. Here, we report the case of a 53-year-old man undergoing a maintenance monotherapy with pemetrexed who presented prolonged pancytopenia despite filgrastim injections. A bone marrow aspiration revealed a macrophage activation syndrome with amastigotes. A Polymerase Chest Reaction testing confirmed the diagnosis of visceral leishmaniasis. Treatment with liposomal amphotericin B was started. Oncologists should bear in mind that visceral leishmaniasis in endemic areas can potentially induce severe and prolonged pancytopenia in immunosuppressed patients, during chemotherapy in particular.
维持化疗是诱导治疗后非进展性晚期 IV 期非鳞状非小细胞肺癌患者的标准治疗方法。在这里，我们报告了一例 53 岁男性患者在接受培美曲塞维持单药治疗时出现了长时间的全血细胞减少症，尽管注射了非格司亭。骨髓抽吸显示巨噬细胞活化综合征伴无鞭毛体。聚合酶链反应检测证实了内脏利什曼病的诊断。开始使用脂质体两性霉素 B 治疗。肿瘤学家应牢记，在利什曼病流行地区，内脏利什曼病可能会导致免疫抑制患者在化疗期间特别是出现严重和长期的全血细胞减少症。
