Related Experiment Video
Updated: Feb 25, 2026
07:43
Using 22C3 Anti-PD-L1 Antibody Concentrate on Biopsy and Cytology Samples from Non-small Cell Lung Cancer Patients
Published on: September 25, 2018
11.1K
Pembrolizumab-Induced Pancytopenia: A Case Report
Dinesh Atwal1, Krishna P Joshi2, Rahul Ravilla3
1Resident Internist at the University of Arkansas for Medical Sciences in Little Rock. datwal@uams.edu.
The Permanente Journal
|July 27, 2017
Summary
Pembrolizumab, a treatment for metastatic melanoma, can cause immune-mediated adverse events. This report details a rare case of pembrolizumab-induced pancytopenia that resolved with corticosteroids and immunoglobulin therapy.
Area of Science:
- Oncology
- Immunology
- Hematology
Background:
- Programmed death receptor-1 (PD-1) blockade with pembrolizumab is an established treatment for metastatic melanoma.
- Cancer immunotherapy can lead to immune-mediated adverse events due to T cell activation.
- Pembrolizumab-induced pancytopenia is a rare and previously unreported adverse event.
Observation:
- A 52-year-old woman with metastatic rectal melanoma developed multiple immune-related adverse events during pembrolizumab therapy.
- These events included colitis, hepatitis, gastritis, vitiligo, and synovitis.
- Severe pancytopenia (Grade 4) occurred after the 18th cycle of pembrolizumab.
Findings:
- The patient's severe pancytopenia resolved following treatment with high-dose corticosteroids and intravenous immunoglobulin therapy.
- Pancytopenia reached its lowest point (nadir) at 10 weeks.
- Meaningful recovery of blood counts was observed over 16 weeks.
Implications:
- This case highlights a novel and severe adverse event associated with pembrolizumab therapy.
- Corticosteroids and intravenous immunoglobulin are effective in managing pembrolizumab-induced pancytopenia.
- Awareness of this potential complication is crucial for oncologists managing patients with melanoma.
