Literature analysis of aplastic anemia/pure red cell aplasia induced by pembrolizumab

LI Yue; ZHANG Shichao; XIE Cheng; ZHU Jianguo; LI Yun

doi:10.6039/j.issn.1001-0408.2025.06.17

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Literature analysis of aplastic anemia/pure red cell aplasia induced by pembrolizumab

更新时间：2025-09-25

- Literature analysis of aplastic anemia/pure red cell aplasia induced by pembrolizumab
- ZHONGGUO YAOFANG Vol. 36, Issue 6, Pages: 737-741(2025)
- 作者机构：
  
  苏州大学附属第一医院药学部，江苏苏州　215000
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2025.06.17
  CLC： R979.1;R556.5
- Received：26 August 2024，
  
  Revised：2025-02-20，
  
  Accepted：26 February 2025，
  
  Published：30 March 2025
- 稿件说明：
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李悦,张诗超,谢诚,等.帕博利珠单抗致再生障碍性贫血/纯红细胞再生障碍性贫血的文献分析[J].中国药房,2025,36(06):737-741.

LI Yue,ZHANG Shichao,XIE Cheng,et al.Literature analysis of aplastic anemia/pure red cell aplasia induced by pembrolizumab[J].ZHONGGUO YAOFANG,2025,36(06):737-741.
李悦,张诗超,谢诚,等.帕博利珠单抗致再生障碍性贫血/纯红细胞再生障碍性贫血的文献分析[J].中国药房,2025,36(06):737-741. DOI： 10.6039/j.issn.1001-0408.2025.06.17.

LI Yue,ZHANG Shichao,XIE Cheng,et al.Literature analysis of aplastic anemia/pure red cell aplasia induced by pembrolizumab[J].ZHONGGUO YAOFANG,2025,36(06):737-741. DOI： 10.6039/j.issn.1001-0408.2025.06.17.

摘要

目的

分析帕博利珠单抗致再生障碍性贫血（AA）/纯红细胞再生障碍性贫血（PRCA）的临床特征，为临床安全用药提供参考。

方法

以“帕博利珠单抗”“贫血”“再生障碍性贫血”“pembrolizumab”“keytruda”“anemia”等为中英文检索词，检索PubMed、Embase、中国知网、万方数据和维普网，收集帕博利珠单抗致AA/PRCA的相关文献并进行描述性统计分析。

结果

共纳入10篇文献，共计10例患者。10例患者中，男性5例、女性5例，65岁以上有5例；原患疾病以转移性黑色素瘤为主（4例）；AA/PRCA的发生时间为帕博利珠单抗第1次用药后13 d～3年，临床表现主要包括疲劳、呼吸急促、口腔/鼻出血、全身紫癜等，其中8例患者出现中度贫血，2例患者出现重度贫血。经停药并予以治疗后，5例患者好转，1例患者贫血加重，4例患者死亡。

结论

临床应用帕博利珠单抗时应定期监测血常规，出现AA/PRCA等相关症状时，应及时停药并根据患者具体情况进行对症治疗，以保障患者的用药安全。

Abstract

OBJECTIVE

To analyze the clinical characteristics of aplastic anemia （AA）/pure red cell aplasia （PRCA） induced by pembrolizumab， and provide reference for clinical safe drug use.

METHODS

Using search terms as “pembrolizumab”， “keytruda”， “anemia” and “aplastic anemia” in both Chinese and English， the literature related to AA/PRCA induced by pembrolizumab were retrieved from PubMed， Embase， CNKI， Wanfang and VIP databases， and then analyzed descriptively and statistically.

RESULTS

A total of 10 patients were included from 10 literature； among these 10 patients， there were 5 males and 5 females， with 5 patients being aged 65 or above. The primary disease was mainly metastatic melanoma （4 cases）. AA/PRCA occurred 13 d-3 years after the first dose of pembrolizumab. The main clinical manifestations included fatigue， dyspnea， oral/nasal bleeding， diffuse purpura， etc.； 8 cases developed moderate anemia and 2 cases developed severe anemia. After discontinuation and receiving supportive therapy， 5 cases improved， 1 case worsened in anemia， and 4 cases died.

CONCLUSIONS

When using pembrolizumab in clinical practice， blood routine should be regularly monitored. When AA/PRCA and other related symptoms occur， pembrolizumab should be stopped in time and a therapy regimen should be formulated according to the patient’ condition， to ensure the safety of medication.

关键词

Keywords

references

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