Itogawa Katsuhiro, Saito Tatsuya, Nakata Yuya, Amari Hikari, Tahara Hiroki, Yoshino Nozomu, Maeda Yuki, Nomura Motoko, Shiihara Jun, Nagai Yoshiaki, Ohta Hiromitsu, Yamaguchi Yasuhiro
Division of Pulmonary Medicine, Jichi Medical University Saitama Medical Center, Japan.
Division of Hematology, Jichi Medical University Saitama Medical Center, Japan.
Intern Med. 2025 Apr 1;64(7):1089-1092. doi: 10.2169/internalmedicine.3961-24. Epub 2024 Sep 4.
We herein report a 64-year-old man with KRAS-mutated advanced lung adenocarcinoma previously treated with immune checkpoint inhibitors (ICIs). One month after starting second-line sotorasib treatment, the patient experienced a progressive decline in serum hemoglobin levels. Anemia was accompanied by markedly elevated serum erythropoietin levels and decreased reticulocyte levels. Bone marrow aspiration revealed pure red cell aplasia. No secondary causes other than medication use were identified. Suspected causative drugs were sotorasib and ICIs. Discontinuation of sotorasib for one week improved his anemia; therefore, the causative drug was identified as sotorasib.
我们在此报告一名64岁的男性，患有KRAS突变的晚期肺腺癌，此前接受过免疫检查点抑制剂（ICIs）治疗。在开始二线索托拉西布治疗一个月后，患者血清血红蛋白水平逐渐下降。贫血伴有血清促红细胞生成素水平显著升高和网织红细胞水平降低。骨髓穿刺显示为纯红细胞再生障碍。除药物使用外，未发现其他继发原因。怀疑的致病药物为索托拉西布和ICIs。停用索托拉西布一周后，他的贫血症状有所改善；因此，确定致病药物为索托拉西布。
