Case Report: Aplastic anemia associated with parvovirus B19 infection following neoadjuvant pembrolizumab-based chemoimmunotherapy for triple-negative breast cancer - Scorecard - MDSpire
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Case Report: Aplastic anemia associated with parvovirus B19 infection following neoadjuvant pembrolizumab-based chemoimmunotherapy for triple-negative breast cancer
Clinical Scorecard: A Case Study of Aplastic Anemia Linked to Parvovirus B19 Following Neoadjuvant Pembrolizumab and Chemotherapy for Triple-Negative Breast Cancer
At a Glance
Category
Detail
Condition
Aplastic Anemia
Key Mechanisms
Immune-related hematologic toxicity and parvovirus B19 infection
Target Population
Patients with triple-negative breast cancer undergoing neoadjuvant therapy
Care Setting
Oncology and hematology clinical settings
Key Highlights
Severe aplastic anemia developed post-neoadjuvant pembrolizumab and chemotherapy.
Bone marrow biopsy indicated generalized bone marrow suppression.
High-dose corticosteroids were ineffective; intravenous immunoglobulin therapy led to recovery.
Importance of distinguishing between infection-triggered and immune-related bone marrow suppression.
Patient remained free of disease recurrence at 20-month follow-up.
Guideline-Based Recommendations
Diagnosis
Broad diagnostic evaluation for severe cytopenias after immunotherapy.
Management
Initiate intravenous immunoglobulin therapy for parvovirus B19 infection.
Monitoring & Follow-up
Regular blood tests to monitor for cytopenias post-treatment.
Risks
Potential for severe hematologic adverse events following immune checkpoint inhibitor therapy.
Patient & Prescribing Data
54-year-old female with triple-negative breast cancer.
Neoadjuvant therapy included pembrolizumab and chemotherapy, with subsequent management of aplastic anemia.
Clinical Best Practices
Consider infectious causes of bone marrow suppression in patients receiving immunotherapy.
Utilize prophylactic measures such as G-CSF during chemotherapy to manage neutropenia.
