Alectinib-Induced Severe Hemolytic Anemia in a Patient with ALK-Positive Non-Small Cell Lung Cancer: A Case Report.
Kazuhito MisawaShinji NakamichiHiroki IidaAtsuhiro NaganoErika MikamiTakehiro TozukaMasaru MatsumotoAkihiko MiyanagaRintaro NoroKaoru KubotaHiroki YamaguchiMasahiro SeikePublished in: OncoTargets and therapy (2023)
Alectinib is a selective anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitor as standard therapy for ALK-rearranged non-small cell lung cancer (NSCLC). Hemolytic anemia is considered as a rare but significant adverse event with alectinib. Here, we report a case of a 73-year-old female with lung adenocarcinoma, harbouring an ALK fusion gene, who received alectinib as second-line therapy and developed gradually progressive grade 4 (6.4 g/dL) drug-induced hemolytic anemia (DIHA) after complete response. We discontinued alectinib and performed a blood transfusion for the severe anemia. The anemia improved with no recurrence of lung adenocarcinoma over 10 months. Regular hematologic monitoring and the possibility of DIHA should be considered in case of progressive hemolytic anemia during alectinib treatment.
Keyphrases
- drug induced
- iron deficiency
- chronic kidney disease
- liver injury
- advanced non small cell lung cancer
- multiple sclerosis
- small cell lung cancer
- emergency department
- gene expression
- diffuse large b cell lymphoma
- adverse drug
- oxidative stress
- copy number
- high glucose
- epidermal growth factor receptor
- genome wide
- endothelial cells
- brain metastases