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Aplastic Anaemia Associated with Bendamustine Therapy - A Rare Side Effect.
Khan, Salman; Yetiskul, Ekrem; Khan, Malik Waleed Zeb; Chavez Reyna, Gabriel; Matra, Amanda; Khattar, Georges; Odaimi, Marcel A.
Afiliación
  • Khan S; Department of Internal Medicine, Staten Island University Hospital/Northwell Health, NY, USA.
  • Yetiskul E; Department of Internal Medicine, Staten Island University Hospital/Northwell Health, NY, USA.
  • Khan MWZ; Department of Internal Medicine, Khyber Teaching Hospital, Peshawar, Pakistan.
  • Chavez Reyna G; Department of Internal Medicine, Staten Island University Hospital/Northwell Health, NY, USA.
  • Matra A; Department of Internal Medicine, Staten Island University Hospital/Northwell Health, NY, USA.
  • Khattar G; Department of Internal Medicine, Staten Island University Hospital/Northwell Health, NY, USA.
  • Odaimi MA; Department of Internal Medicine, Staten Island University Hospital/Northwell Health, NY, USA.
Eur J Case Rep Intern Med ; 11(3): 004339, 2024.
Article en En | MEDLINE | ID: mdl-38455694
ABSTRACT

Introduction:

During treatment for malignant lymphoma, cytopenia can develop for several reasons. This can range from mild cytopenias leading to infection and bleeding to full-blown drug-induced aplastic anaemia. While aplastic anaemia affects individuals of all genders and ages, here, we describe aplastic anaemia after chemotherapy exposure to bendamustine in a 65-year-old female with non-Hodgkin's lymphoma. Case description A 65-year-old woman with recurrent indolent marginal zone lymphoma and post-chemotherapy with bendamustine and rituximab, presented with a neutropenic fever and was admitted with a leading diagnosis of sepsis. In the previous two weeks, the patient required regular transfusions of packed red blood cells and platelets and maintained a daily ZARXIO® regimen. Laboratory results revealed pancytopenia, and broad-spectrum antibiotics (cefepime/vancomycin) were given. The patient was subsequently admitted to the hospital under the care of the haematology/oncology team and was ultimately diagnosed with aplastic anaemia, likely as a consequence of bendamustine chemoimmunotherapy. She elicited a positive response to the triple immunosuppressive therapy (IST) regimen (two immunotherapeutic agents plus one anti-thymocyte globulin (ATG), after which her cell counts returned to normal.

Conclusions:

This case underscores the importance of recognising haematologic complications linked to bendamustine and advocates for further research to increase the understanding among healthcare professionals of drug-induced aplastic anaemia. Bendamustine can cause severe autoimmune haemolytic anaemia and aplastic anaemia and may require multiple transfusions and a multidrug regimen for treatment. The use of ATG as a therapeutic intervention is appropriate because it has been effective in treating aplastic anaemia. LEARNING POINTS Bendamustine can cause severe autoimmune haemolytic anaemia and aplastic anaemia, a side effect which has rarely been reported but is of significant clinical importance.Drug-induced aplastic anaemia is a complex, potentially devastating consequence of treating blood cancers and is a relatively unexplored area that requires further understanding.Anti-thymocyte globulin is effective in treating bendamustine-induced aplastic anaemia as it degrades lymphocytes that destroy the bone marrow.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Idioma: En Revista: Eur J Case Rep Intern Med Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Idioma: En Revista: Eur J Case Rep Intern Med Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos