Acute myeloid leukemia and myelodysplastic syndrome associated with a combination of immune checkpoint inhibitor and platinum‐based chemotherapy

• Published in: Thoracic cancer 2023-08, Vol.14 (22), p.2225-2228
• Main Authors: Nakatsuru, Kousei, Tsubouchi, Kazuya, Hirahata, Minori, Nakashima, Tadayuki, Takahata, Yuriko, Okamatsu, Yuki, Shiraishi, Yoshimasa, Okamoto, Isamu, Harada, Taishi
• Format: Article
• Language: English
• Subjects: acute myeloid leukemia; Anemia; autoimmune hemolytic anemia; Biopsy; Bone marrow; Cancer therapies; Case Report; Case Reports; Chemotherapy; Hematology; Humans; immune checkpoint inhibitors; Immune Checkpoint Inhibitors - therapeutic use; Immunotherapy; Leukemia; Leukemia, Myeloid, Acute - drug therapy; Leukemia, Myeloid, Acute - etiology; Leukemia, Myeloid, Acute - pathology; Leukocytes; Liver; Lung cancer; Lymphatic system; Metastasis; myelodysplastic syndrome; Myelodysplastic syndromes; Myelodysplastic Syndromes - drug therapy; Myelodysplastic Syndromes - etiology; Myelodysplastic Syndromes - pathology; Neoplasms, Second Primary - drug therapy; Neutropenia; Pharmaceutical industry; Prognosis; Steroids; Supervision; Tomography; Tumors; Writing
• ISSN: 1759-7706; 1759-7714
• DOI: 10.1111/1759-7714.15005

Therapy related‐acute myeloid leukemia (t‐AML) and myelodysplastic syndrome (t‐MDS) are complications of chemotherapy and/or radiation therapy for malignant diseases. In this report, we describe a patient with advanced lung adenocarcinoma who developed autoimmune hemolytic anemia and MDS associated with a combination of atezolizumab and platinum‐based chemotherapy. The patient showed progression from t‐MDS to t‐AML 20 months after the treatment was initiated. A combination of immune checkpoint inhibitor (ICI) and chemotherapy may increase the risk of developing therapy‐related myeloid neoplasms. As the prognosis of t‐AML and t‐MDS is poorer than that of de novo AML and MDS, proper surveillance, follow‐up, and treatment are needed throughout the course of immunotherapy. We report a patient with advanced lung adenocarcinoma who developed autoimmune hemolytic anemia and myelodysplastic syndrome (MDS) associated with a combination of atezolizumab and platinum‐based chemotherapy. The patient showed progression from therapy related MDS to therapy related AML 20 months after the treatment was initiated. A combination of immune checkpoint inhibitor and chemotherapy may increase the risk of developing therapy related myeloid neoplasms.