Department of Pulmonary Medicine, Nippon Medical School Musashi Kosugi Hospital.
Department of Diagnostic Pathology, Nippon Medical School Musashi Kosugi Hospital.
J Nippon Med Sch. 2024;91(3):339-346. doi: 10.1272/jnms.JNMS.2024_91-302.
Immune check point inhibitors (ICIs) have durable antitumor effects. However, autoimmune toxicities, termed immune-related adverse events, occur in some patients. We report a case of severe immune aplastic anemia (AA) in a patient with non-small cell lung cancer who was receiving atezolizumab with bevacizumab/carboplatin/paclitaxel. Although the cancer has not recurred, his bone marrow is depleted and he did not respond to immunosuppressive therapy. He has survived for 1.5 years with blood transfusions and infection control. Immune AA associated with ICIs is rare, and a treatment has not yet been established. This case report provides information on the management and treatment response of patients with AA caused by ICIs. Further studies should investigate the mechanism and pathogenesis of immune AA caused by ICIs.
免疫检查点抑制剂（ICIs）具有持久的抗肿瘤作用。然而，一些患者会出现自身免疫毒性，称为免疫相关不良事件。我们报告了一例非小细胞肺癌患者在接受阿特珠单抗联合贝伐珠单抗/卡铂/紫杉醇治疗时发生严重免疫性再生障碍性贫血（AA）的病例。尽管癌症未复发，但他的骨髓已耗竭，且对免疫抑制治疗无反应。他通过输血和感染控制存活了 1.5 年。与 ICIs 相关的免疫性 AA 较为罕见，且尚未确立治疗方法。本病例报告提供了有关 ICIs 引起的 AA 患者的管理和治疗反应的信息。进一步的研究应探讨 ICIs 引起的免疫性 AA 的机制和发病机制。
