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Pembrolizumab-induced Pure Red Cell Aplasia Successfully Treated with Intravenous Immunoglobulin

Atsushi Isoda1,2, Yuri Miyazawa1, Kenichi Tahara1

  • 1Department of Hematology, National Hospital Organization Shibukawa Medical Center, Japan.

Internal Medicine (Tokyo, Japan)
|May 12, 2020
PubMed

We herein report a 64-year-old man who was treated with pembrolizumab for relapsed Hodgkin lymphoma. After the third administration of pembrolizumab, he showed acute anemia with a positive direct anti-globulin test. Because of the markedly erythroid hypoplasia, he was diagnosed with pure red cell aplasia (PRCA) caused by pembrolizumab. He was initially treated with prednisolone, but the reticulocytes decreased after tapering prednisolone. He then received high-dose intravenous immunoglobulin (IVIG) with prednisolone, and PRCA was successfully treated. Although the pathogenesis of PRCA caused by immune checkpoint inhibitors (CPIs) remains unclear, IVIG treatment may be effective for some steroid-refractory CPI-induced PRCA cases.

Keywords:
direct anti-globulin testimmune-related adverse eventsintravenous immunoglobulinpembrolizumabprogramed cell death 1pure red cell aplasia

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