Case Report and Literature Review of Severe Anemia Secondary to Chemotherapy Combined with PD-1 Monoclonal Antibody Immunotherapy for Lung Adenocarcinoma

TL;DR

A lung cancer patient developed severe anemia after chemotherapy and PD-1 antibody treatment, which improved with high-dose steroids.

Contribution

This case provides new clinical insights into managing rare anemia caused by PD-1 monoclonal antibody immunotherapy.

Findings

A patient with lung adenocarcinoma developed severe anemia following chemotherapy and PD-1 antibody treatment.

High-dose corticosteroid therapy led to significant improvement in hemoglobin levels.

The case highlights the potential role of inflammatory anemia in immune-related adverse events.

Abstract

程序性细胞死亡受体1（programmed cell death 1, PD-1）单抗治疗肺腺癌可能引起罕见而严重的血液学不良反应，可出现重症贫血等表现。尽管糖皮质激素被推荐用于免疫相关不良事件的管理，但针对PD-1单抗诱发的重症贫血的治疗经验仍十分有限，其疗效和安全性尚未充分验证。本文报道了1例化疗联合PD-1单抗治疗后发生重症贫血的晚期肺腺癌患者，经过系列检查，考虑诊断炎症性贫血，经足量糖皮质激素治疗后，血红蛋白显著回升，以期为临床中这类罕见血液学毒性的识别和治疗提供新的见解。

A: Pre-treatment chest CT (mediastinal window); B: Post-treatment chest CT (mediastinal window) after two cycles of immunotherapy combined with chemotherapy. CT: computed tomography.

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