Alectinib-induced Immune Hemolytic Anemia in a Patient with Lung Adenocarcinoma

Drug-induced immune hemolytic anemia (DIIHA) is a rare condition with an increasing incidence associated with the frequent use of certain drugs. An 85-year-old woman with lung adenocarcinoma prescribed alectinib complained of dyspnea on exertion at our hospital. Based on her laboratory tests results on admission, we focused on the clinical course of anemia and hemolysis progression after alectinib administration. The patient's anemia and hemolysis gradually improved after discontinuation of alectinib, leading to a diagnosis of alectinib-induced IHA, presented here as the first case encountered in a patient with lung adenocarcinoma. Furthermore, we discuss the importance of correlating clinical laboratory findings in DIIHA.

[1]  T. Doman,et al.  The Folate Pathway Inhibitor Pemetrexed Pleiotropically Enhances Effects of Cancer Immunotherapy , 2019, Clinical Cancer Research.

[2]  Tsuyoshi Takahashi Direct Antiglobulin Test-Negative Autoimmune Hemolytic Anemia , 2018, Acta Haematologica.

[3]  B. Solomon,et al.  Treatment of ALK-positive nonsmall cell lung cancer: recent advances , 2017, Current opinion in oncology.

[4]  U. Khan,et al.  Immunotherapy-associated autoimmune hemolytic anemia , 2017, Journal of Immunotherapy for Cancer.

[5]  C. Tormey,et al.  The Direct Antiglobulin Test: Indications, Interpretation, and Pitfalls. , 2017, Archives of pathology & laboratory medicine.

[6]  P. Ruestow,et al.  Lung cancer mutation profile of EGFR, ALK, and KRAS: Meta-analysis and comparison of never and ever smokers. , 2016, Lung cancer.

[7]  T. Kamesaki [Diagnosis and treatment of hemolytic anemia]. , 2015, [Rinsho ketsueki] The Japanese journal of clinical hematology.

[8]  B. Mennecier,et al.  Anémie hémolytique sous traitement par erlotinib , 2013 .

[9]  K. Rezvani,et al.  Tyrosine kinase inhibitors impair B-cell immune responses in CML through off-target inhibition of kinases important for cell signaling. , 2013, Blood.

[10]  M. Blajchman,et al.  Warm autoimmune hemolytic anemia: recent progress in understanding the immunobiology and the treatment. , 2010, Transfusion medicine reviews.

[11]  G. Garratty Immune hemolytic anemia associated with drug therapy. , 2010, Blood reviews.

[12]  B. Gerber,et al.  [Autoimmune hemolytic anemia]. , 2010, Therapeutische Umschau. Revue therapeutique.

[13]  K. Ozawa,et al.  Cut‐off value of red‐blood‐cell‐bound IgG for the diagnosis of Coombs‐negative autoimmune hemolytic anemia , 2009, American journal of hematology.

[14]  G. Garratty Immune hemolytic anemia associated with negative routine serology. , 2005, Seminars in hematology.

[15]  R. Friedberg,et al.  Autoimmune hemolytic anemia , 2002, American journal of hematology.

[16]  T. Lamy,et al.  Warm autoimmune hemolytic anemia: Advances in pathophysiology and treatment , 2014 .

[17]  Y. Yawata [Hemolytic anemia]. , 1994, Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine.