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A Rare Case of Hemolytic Anemia after Alectinib That Did Not Recur after Switching to Lorlatinib
X Tonnar1, Cornelius F Waller1
1Department of Medicine I, Medical Center, University of Freiburg, Freiburg, Germany.
Introduction:
We would like to share the case of a 55-year-old male patient with ALK-positive lung cancer with a corpuscular hemolytic anemia following alectinib therapy.
Case Presentation:
Approximately 7 weeks after initiating alectinib therapy, this patient developed anemia. Laboratory tests revealed a new Coombs-negative hemolysis with adequate substrate levels, an increase in indirect bilirubin, reticulocytes, and undetectable haptoglobin levels. Cytomorphology primarily showed numerous acanthocytes. This presentation aligns with a case reported in Japan, describing severe hemolytic anemia with morphological changes in erythrocytes under alectinib treatment.
Conclusion:
This is the first report describing a rapid increase in hemoglobin after pausing alectinib and no relapse of hemolysis after switching to lorlatinib, while the lung cancer remained stable (stable disease).
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