• Internal medicine · Jul 2023

    Case Reports

    Successful Steroid Treatment of Pembrolizumab-induced Agranulocytosis that Developed after Splenectomy in a Patient with Non-small-cell Lung Cancer: A Case Report.

    • Shinichi Okuzumi, Hirofumi Kamata, Katsura Emoto, Takayuki Shimizu, Shiro Otake, Hidehiro Irie, Shotaro Chubachi, Shinnosuke Ikemura, Hiroyuki Yasuda, and Koichi Fukunaga.
    • Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Japan.
    • Intern. Med. 2023 Jul 15; 62 (14): 211321212113-2121.

    AbstractNeutropenia, a rare immune-related adverse event, affects patients receiving treatment with immune checkpoint inhibitors (ICIs). We herein report a case of pembrolizumab-induced agranulocytosis. An 83-year-old man was diagnosed with advanced-stage lung carcinoma concomitant with splenomegaly complicated by hypersplenism, causing pancytopenia. To avoid the risk of bone marrow suppression due to cytotoxic chemotherapy, pembrolizumab monotherapy was chosen. However, the patient developed agranulocytosis despite the resolution of pancytopenia through splenectomy performed after the fourth pembrolizumab cycle. Neutrophil counts improved after steroid treatment but not after granulocyte colony-stimulating factor treatment. This case demonstrated that neutropenia can sometimes develop abruptly after several ICI therapy cycles.

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