Skip to content
DraconiticResearch
Search Sources API
194,220 studies31 sourcesUpdated 5 min ago
Peer-reviewedCC BYThe oncologist

Immune checkpoint inhibitors induced autoimmune hemolytic anemia in patients with malignant cancer.

  • Aoxi Liang1
  • Yuanqiang Wu1
  • Shengchi Chen2
  • Jisheng Li3
  • Yue Pan4,5
  • Yixing Luo6
  • Yue Zeng1
  • Shijiao Yao1
  • Shuxing Wang1,6
  • Chunhong Hu1,7
  • Xianling Liu1,8
  • Fang Wu1,7,9,10,11,12
12 affiliations
  1. 1Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha 410011, China.
  2. 2Department of Oncology, Nanping First Hospital Affiliated to Fujian Medical University, Nanping 353000, China.
  3. 3Department of Medical Oncology, Qilu Hospital of Shandong University, Jinan 250012, China.
  4. 4Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
  5. 5Department of Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
  6. 6Xiangya School of Medicine, Central South University, Changsha 410013, China.
  7. 7Hunan Cancer Mega-Data Intelligent Application and Engineering Research Centre, Changsha 410011, China.
  8. 8Department of Oncology, Guilin Hospital of the Second Xiangya Hospital, Central South University, Guilin 541100, China.
  9. 9Hunan Key Laboratory of Tumor Models and Individualized Medicine, The Second Xiangya Hospital, Central South University, Changsha 410011, China.
  10. 10Hunan Key Laboratory of Early Diagnosis and Precision Therapy in Lung Cancer, The Second Xiangya Hospital, Central South University, Changsha 410011, China.
  11. 11FuRong Laboratory, Changsha 410078, China.
  12. 12Changsha Thoracic Cancer Prevention and Treatment Technology Innovation Center, Changsha 410011, China.
Read full textPDFDOICite

Abstract

Background

Autoimmune hemolytic anemia (AIHA) is a rare but potentially life-threatening hematologic immune-related adverse event (irAE) associated with immune checkpoint inhibitors (ICIs). This study reports 3 new cases of ICI-induced AIHA from three medical centers in China and places them in the context of existing literature.Methods

Three patients with AIHA following ICI therapy were identified from The Second Xiangya Hospital, Qilu Hospital, and Nanping First Hospital. A PubMed search up to June 1, 2026, was conducted to collect previously reported cases with sufficient clinical details.Results

A total of 51 cases were analyzed, including three new patients and 48 from published reports. The mean age was 65.2 years, and 47.1% were male. The most common tumor types were melanoma (49.0%) and non-small cell lung cancer (27.5%). Most cases were associated with anti-PD-1 agents, particularly pembrolizumab and nivolumab, and AIHA typically developed early during ICI therapy. Corticosteroids were the primary treatment, with 92.2% achieving hematologic recovery or improvement. Four deaths (7.8%) were attributed to severe hemolysis. All three newly identified patients had pre-existing anemia before ICI initiation.Conclusions

ICI-induced AIHA usually occurs early during ICI therapy and responds favorably to corticosteroid-based treatment. Pre-existing anemia in our cases should be regarded as a hypothesis-generating observation rather than evidence of a specific risk factor, underscoring the need for early hemolysis work-up and close monitoring when anemia worsens after ICI exposure.

Related

  1. Risk of de novo immune-related adverse events in patients with cancer and autoimmune disease receiving immune checkpoint inhibitors
    Rotana M. Radwan, Grant D. Scheiffele, Wenxi Huang +9
    Communications MedicinePeer-reviewedCC BY 4.0General medicineNatureCrossref
  2. [Clinical characteristics and prognosis of patients with direct antiglobulin test-negative autoimmune hemolytic anemia].
    J A Zhang, J W Qiu, J Shi +4
    Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhiPeer-reviewedCC BYFull textGeneral medicineEurope PMC
  3. REAL-WORLD TREATMENT PATTERNS AND CLINICAL OUTCOMES OF PATIENTS WITH PRIMARY AUTOIMMUNE HEMOLYTIC ANEMIA IN BRAZIL: A CLAIMS DATABASE STUDY
    Renato Watanabe DE OLIVEIRA, Ligia Taveira Engler Raiz COELHO, Gabriela Ana KANEVSKY +3
    Hematology, Transfusion and Cell TherapyPeer-reviewedCC BYFull textEndocrinology & metabolismDOAJ
  4. Association of pre-existing cardiovascular disease with cardiovascular and clinical outcomes in patients receiving immune checkpoint inhibitors
    Lama Alfehaid, Ahmed S. Alanazi, Mansour Alomran +2
    Scientific ReportsPeer-reviewedCC BY-NC-ND 4.0Full textOncologyCrossref
  5. 971 The impact of liver metastases on immune-related adverse events in stage IV patients treated with immune-checkpoint inhibitors: a real-world, multicenter, retrospective study
    Adil Alaoui, Jessica A Catterson, Michael B Atkins +4
    Journal for ImmunoTherapy of CancerPeer-reviewedCC BYFull textOncologyDOAJ

Cite

BibTeXRIS
BibTeX
@article{liang2026immune,
  title = {{Immune checkpoint inhibitors induced autoimmune hemolytic anemia in patients with malignant cancer.}},
  author = {Aoxi Liang and Yuanqiang Wu and Shengchi Chen and Jisheng Li and Yue Pan and Yixing Luo and Yue Zeng and Shijiao Yao and Shuxing Wang and Chunhong Hu and Xianling Liu and Fang Wu},
  journal = {The oncologist},
  year = {2026},
  month = oct,
  doi = {10.1093/oncolo/oyag395},
  url = {https://europepmc.org/article/MED/42853111},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Immune checkpoint inhibitors induced autoimmune hemolytic anemia in patients with malignant cancer.
AU  - Aoxi Liang
AU  - Yuanqiang Wu
AU  - Shengchi Chen
AU  - Jisheng Li
AU  - Yue Pan
AU  - Yixing Luo
AU  - Yue Zeng
AU  - Shijiao Yao
AU  - Shuxing Wang
AU  - Chunhong Hu
AU  - Xianling Liu
AU  - Fang Wu
PY  - 2026
DA  - 2026/10/01
JO  - The oncologist
DO  - 10.1093/oncolo/oyag395
UR  - https://europepmc.org/article/MED/42853111
AB  - Background  Autoimmune hemolytic anemia (AIHA) is a rare but potentially life-threatening hematologic immune-related adverse event (irAE) associated with immune checkpoint inhibitors (ICIs). This study reports 3 new cases of ICI-induced AIHA from three medical centers in China and places them in the context of existing literature.Methods  Three patients with AIHA following ICI therapy were identified from The Second Xiangya Hospital, Qilu Hospital, and Nanping First Hospital. A PubMed search up to June 1, 2026, was conducted to collect previously reported cases with sufficient clinical details.Results  A total of 51 cases were analyzed, including three new patients and 48 from published reports. The mean age was 65.2 years, and 47.1% were male. The most common tumor types were melanoma (49.0%) and non-small cell lung cancer (27.5%). Most cases were associated with anti-PD-1 agents, particularly pembrolizumab and nivolumab, and AIHA typically developed early during ICI therapy. Corticosteroids were the primary treatment, with 92.2% achieving hematologic recovery or improvement. Four deaths (7.8%) were attributed to severe hemolysis. All three newly identified patients had pre-existing anemia before ICI initiation.Conclusions  ICI-induced AIHA usually occurs early during ICI therapy and responds favorably to corticosteroid-based treatment. Pre-existing anemia in our cases should be regarded as a hypothesis-generating observation rather than evidence of a specific risk factor, underscoring the need for early hemolysis work-up and close monitoring when anemia worsens after ICI exposure.
SN  - 1083-7159
SN  - 1549-490X
ER  -