OncoTargets and Therapy (Jan 2023)

Alectinib-Induced Severe Hemolytic Anemia in a Patient with ALK-Positive Non-Small Cell Lung Cancer: A Case Report

  • Misawa K,
  • Nakamichi S,
  • Iida H,
  • Nagano A,
  • Mikami E,
  • Tozuka T,
  • Matsumoto M,
  • Miyanaga A,
  • Noro R,
  • Kubota K,
  • Yamaguchi H,
  • Seike M

Journal volume & issue
Vol. Volume 16
pp. 65 – 69

Abstract

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Kazuhito Misawa,1 Shinji Nakamichi,1 Hiroki Iida,1 Atsuhiro Nagano,1 Erika Mikami,1 Takehiro Tozuka,1 Masaru Matsumoto,1 Akihiko Miyanaga,1 Rintaro Noro,1 Kaoru Kubota,1 Hiroki Yamaguchi,2 Masahiro Seike1 1Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, 113-8603, Japan; 2Department of Hematology, Nippon Medical School, Tokyo, 113-8603, JapanCorrespondence: Shinji Nakamichi, Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan, Tel +81-3-3822-2131, Email [email protected]: 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.Keywords: non-small cell lung cancer, ALK, alectinib, drug-induced hemolytic anemia

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