Case report: A rare case of acute hemolysis in advanced rectal cancer after XELOX and nivolumab treatment: analysis of drug-dependent antibodies

Frontiers in Medicine

Medicine

Chunyan Wu¹  Qiao Song¹  Dengke Zhao²  Shuye Wang³ 

[1] Department of Medicine, Qingdao University, Qingdao, China;Department of Hematology, Affiliated Hospital, Qingdao University, Qingdao, China;Harbin Medical University, Harbin, China;Harbin Medical University, Harbin, China;Department of Hematology, The First Affiliated Hospital, Harbin Medical University, Harbin, China;

关键词: drug-related hemolytic anemia;    colorectal cancer;    oxaliplatin;    nivolumab;    treatment;   

DOI  :  10.3389/fmed.2023.1167759

 received in 2023-03-09, accepted in 2023-05-09,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectiveTo investigate the mechanism, in vitro differential test and clinical significance of hemolytic anemia after receiving oxaliplatin and nivolumab treatment.MethodsWe encountered a male patient with stage IV rectal cancer who experienced acute hemolysis during the ninth cycle of treatment with XELOX combined with nivolumab and cetuximab. The patient's blood samples were collected and tested for the presence of oxaliplatin or nivolumab antibodies on red blood cells.ResultsDirect antiglobulin testing of red blood cells incubated with oxaliplatin was strongly positive, whereas cells incubated with nivolumab were negative, which suggested that oxaliplatin was responsible for the hemolysis. After short-term highdose glucocorticoid treatment, human normal immunoglobulin infusion, and other symptomatic treatments, the patient's condition rapidly improved, and he continued to receive nivolumab treatment without further hemolysis.ConclusionAttention should be paid to the possibility of acute hemolysis when using oxaliplatin and nivolumab, and it is important to recognize and manage this adverse event early. We detected oxaliplatin-related antibodies on the surface of red blood cells in vitro, which provided evidence for the following treatments.

【 授权许可】

Unknown   
Copyright © 2023 Zhao, Song, Wu and Wang.