Boumeghar K, Buchbinder N, Metot C, Bera E, Picard V, Modot T, Gallais F, Daliphard S, Bobée V. Hemolytic Anemia With Acanthocytes During Alectinib Treatment of Anaplastic T-Cell Lymphoma: A Case Report and Literature Review.
J Pediatr Hematol Oncol 2025;
47:123-126. [PMID:
39961014 DOI:
10.1097/mph.0000000000003003]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2024] [Accepted: 01/10/2025] [Indexed: 03/25/2025]
Abstract
Alectinib, an ALK inhibitor used for ALK+ non-small cell lung cancer and other malignancies, has been associated with anemia and RBC abnormalities, including acanthocytosis. We report the first case of alectinib-induced acanthocytosis and hemolysis causing anemia during treatment for anaplastic large cell lymphoma in an 11-year-old boy. Extensive testing, including next-generation sequencing, and a specific indirect antiglobulin test conducted with alectinib, was performed to document this hemolytic anemia. Dose reduction improved hemoglobin levels, allowing completion of the 2-year treatment, suggesting a dose-dependent mechanism. Blood counts and morphology normalized after discontinuation of alectinib. A comprehensive literature review and discussion of the underlying mechanisms are also provided.
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