Open Access Peer-reviewed Case Report

A case of life threatening acute Nivolumab induced autoimmune haemolytic anaemia

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Abdul Rehman Farooq corresponding author
Clodagh Keohane
Maeve Crowley
Laura Whelan
Neasa Gallwey
Claire Brady
Seamus O'Reilly


Autoimmune haemolytic anemia is a rare but potentially catastrophic adverse event of im-mune checkpoint inhibitor therapy. We present the case of a gentleman who presented with non-specific symptoms while undergoing adjuvant Nivolumab therapy after potential-ly curative surgery for gastroesophageal cancer. The patient’s haemoglobin deteriorated to 4.7 g/dl with no evidence of bleeding and serologic tests indicative of hemolysis. He re-ceived emergent massive RCC transfusion receiving 9 units of bloods in 1 night, and was commenced on high dose methylprednisolone. During subsequent weeks of inpatient care, the patient continued to received multiple daily red cell transfusions and had a total of 53 RCC transfusions during admission, along with high doses of steroids,4 doses of weekly Rituximab as well as 2 doses of IVIG.While he was discharged on day 38 of admission, he required a slow taper of steroids over 6 months. Immune related hemolytic anemias are a rare corollary of immune check point inhibitors. The cases of immune related AIHA docu-mented in the literature were treated with steroids, Rituximab and IVIG, which are also rec-ommended by guidelines for the treatment of immune related haemolytic anemias.

autoimmune haemolytic anemia, Nivolumab, hemolysis, hematologic toxicity, immunotherapy, immune related toxicity

Article Details

Supporting Agencies
The clinical trials unit is funded through the Health Research Board (Project No. CTIC- 2021-002), UCC Cancer Trials Group, University College Cork, HRB Cancer Trials in Ireland, 2021.
How to Cite
Farooq, A. R., Keohane, C., Crowley, M., Whelan, L., Gallwey, N., Brady, C., & O’Reilly, S. (2022). A case of life threatening acute Nivolumab induced autoimmune haemolytic anaemia. Current Cancer Reports, 4(1), 133-138.


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