title: Severe immune hemolytic anemia due to pemetrexed in a patient with non-small cell lung cancer.
abstract: Pemetrexed-induced immune hemolytic anemia is a rare acute complication and a potentially life-threatening syndrome. Here we report a case of severe hemolytic anemia induced by pemetrexed in a 67-year-old man with lung adenocarcinoma. Hemoglobin concentration reached a nadir of 6.8 g/dl after 6 days of pemetrexed initiation. Pemetrexed was discontinued and the patient was given a transfusion of red blood cells. The direct antiglobulin test was positive (anti-IgG = 4+, anti-C3d = 2+). The patient's plasma reacted with pemetrexed-treated red blood cells by the immune complex test.
authors: Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
authors: Xiaojiang
authors: X
authors: Sun
authors: Liming
authors: L
authors: Sheng
authors: Qinghua
authors: Q
authors: Deng
authors: Peng
authors: P
authors: Liu
authors: Ke
authors: K
authors: Lu
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000188:drug therapy; D000368:Aged; D000743:Anemia, Hemolytic / Q000097:blood / Q000139:chemically induced*; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood* / Q000188:drug therapy; D004909:Erythrocyte Indices; D005971:Glutamates / Q000009:adverse effects*; D006147:Guanine / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D000068437:Pemetrexed; D013940:Thymidylate Synthase / Q000037:antagonists & inhibitors
chemical_list: D000964:Antimetabolites, Antineoplastic; D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine; D013940:Thymidylate Synthase