AUTHOR=Tan Qiaoyun , Liu Lichao , Huang Yu , Dong Xiaorong , Chen Lingjuan 

TITLE=Case report: A rare case of neutropenia caused by pembrolizumab in squamous lung cancer and literature review

JOURNAL=Frontiers in Oncology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.973421

DOI=10.3389/fonc.2022.973421

ISSN=2234-943X

ABSTRACT=Background: Immune checkpoint inhibitors, including anti-PD1 therapies, have prolonged overall survival in patients with a variety of cancers, and immunotherapy is sometimes associated with immune-related adverse events (irAEs); however, hematological toxicity especially neutropenia is rare.
Case presentation: A 78-year-old man with squamous lung cancer, with brain metastasis, was treated with pembrolizumab and albumin-bound paclitaxel as first-line treatment for one cycle, and changed to pembrolizumab plus anlotinib at the second cycle. After two cycles of therapies, grade 4 neutropenia was developed which mainly contributed to irAE related. The patient was started on granulocyte colony-stimulating factor (G-CSF) but without improvement, then treated with corticosteroids, and neutrophil counts gradually back to normal. However, the patient eventually died because of neurological problems.
Conclusion: Grade 4 neutropenia associated with ICI, although rare, is often severe and presents with infectious complications, clinicians need to diagnose timely and get acknowledgment of prompt and proper management to such patients.