Immune Suppression Therapy in Aplastic Anemia Secondary to Atezolizumab in a Patient With Stage IV Non-Small Cell Lung Cancer

Abstract

Immune checkpoint blockade therapy (ICB) targets immune suppressive checkpoint proteins, such as programmed cell death 1 (PD-1) / programmed cell death ligand 1 (PD-L1) and cytotoxic T-lymphocyte antigen 4 (CTLA 4) pathways. It exhibits a significant advantage in non-small cell lung cancer (NSCLC) treatment. Number of Patients with immune related adverse events (irAEs) are likely to grow due to the large amounts of patients being administered ICB for NSCLC. This report demonstrates a case of aplastic anemia (AA) secondary to ICB therapy in a patient with NSCLC, and a specific treatment for the AA by immune suppression therapy (IS). The study of IS therapy indicates it is an important therapeutic tool for patients with AA; however, it is unclear how IS therapy works for NSCLC patients with a secondary AA under an ICB treatment. This clinical case provides a positive result and indicates IS therapy can be used on AA secondary to ICB therapy. More study is needed to investigate for potential side effects of this treatment.