-Case Reports-

A Case of Immune Aplastic Anemia during Combined Treatment with Atezolizumab and Chemotherapy for Non-Small Cell Lung Cancer

Satoru Matsuki¹, Namiko Taniuchi¹, Naoko Okada¹, Junpei Sato¹, Nobuhiko Nishijima¹, Koichiro Kamio¹, Norio Motoda², Muneo Okamoto³, Masahiro Seike⁴ and Arata Azuma¹

¹Department of Pulmonary Medicine, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan
²Department of Diagnostic Pathology, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan
³Department of Hematology, Nippon Medical School, Tokyo, Japan
⁴Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan

Immune check point inhibitors (ICIs) have durable antitumor effects. However, autoimmune toxicities, termed immune-related adverse events, occur in some patients. We report a case of severe immune aplastic anemia (AA) in a patient with non-small cell lung cancer who was receiving atezolizumab with bevacizumab/carboplatin/paclitaxel. Although the cancer has not recurred, his bone marrow is depleted and he did not respond to immunosuppressive therapy. He has survived for 1.5 years with blood transfusions and infection control. Immune AA associated with ICIs is rare, and a treatment has not yet been established. This case report provides information on the management and treatment response of patients with AA caused by ICIs. Further studies should investigate the mechanism and pathogenesis of immune AA caused by ICIs.

J Nippon Med Sch 2024; 91: 339-346

Keywords
atezolizumab, aplastic anemia, immune checkpoint inhibitor, immune-related adverse event, non-small cell lung cancer

Correspondence to
Namiko Taniuchi, Department of Pulmonary Medicine, Nippon Medical School Musashi Kosugi Hospital, 1-383 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa 211-8533, Japan
taniuchi@nms.ac.jp

Received, November 22, 2022
Accepted, March 15, 2023