{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T09:23:33Z","timestamp":1792315413799,"version":"4.4.0"},"reference-count":18,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,4,1]]},"abstract":"<jats:p>With growing use of nivolumab, rare but serious side effects have surfaced in some patients. We present a case of autoimmune haemolytic anaemia that developed after 39 cycles of nivolumab. A 78-year-old man with metastatic lung adenocarcinoma, refractory to multiple lines of chemotherapy was switched to nivolumab. After around 2 years of stable course on nivolumab, he developed transfusion-dependent anaemia with haemoglobin of 8.6\u2009g\/dL. Nivolumab was held immediately. Bone marrow biopsy findings were inconclusive of myelodysplastic syndrome. Further testing was suggestive of haemolysis with haptoglobin &lt;10\u2009mg\/dL, elevated reticulocyte count and identification of immunoglobulin G antibody. Haemoglobin improved significantly with initiation of 1\u2009mg\/kg prednisone in addition to rituximab weekly \u00d7 four doses. The development of transfusion-dependent anaemia with the exposure to cytotoxic chemotherapy usually raises the question for myelodysplastic syndrome. In contradiction, our patient was diagnosed to have a haematological autoimmune complication related to immunotherapy.<\/jats:p>","DOI":"10.1136\/bcr-2018-224608","type":"journal-article","created":{"date-parts":[[2018,4,18]],"date-time":"2018-04-18T09:15:20Z","timestamp":1524042920000},"page":"bcr-2018-224608","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["A case of autoimmune haemolytic anaemia after 39 cycles of nivolumab"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5604-4166","authenticated-orcid":false,"given":"Hira","family":"Shaikh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nour","family":"Daboul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Albrethsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salman","family":"Fazal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,4,18]]},"reference":[{"key":"2025042703254659000_2018.apr17_2.bcr-2018-224608.1","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s12916-016-0571-0","article-title":"Advances in immunotherapy for melanoma","volume":"14","author":"Redman","year":"2016","journal-title":"BMC Med"},{"key":"2025042703254659000_2018.apr17_2.bcr-2018-224608.2","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1517\/14712598.2015.1114097","article-title":"Nivolumab for treating non-small cell lung cancer","volume":"15","author":"Guibert","year":"2015","journal-title":"Expert Opin Biol Ther"},{"key":"2025042703254659000_2018.apr17_2.bcr-2018-224608.3","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1080\/17425255.2016.1214713","article-title":"Pharmacokinetics, pharmacodynamics and clinical efficacy of nivolumab in the treatment of metastatic renal cell carcinoma","volume":"12","author":"Farolfi","year":"2016","journal-title":"Expert Opin Drug Metab Toxicol"},{"key":"2025042703254659000_2018.apr17_2.bcr-2018-224608.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1411087"},{"key":"2025042703254659000_2018.apr17_2.bcr-2018-224608.5","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.60.0379"},{"key":"2025042703254659000_2018.apr17_2.bcr-2018-224608.6","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1097\/CMR.0000000000000232","article-title":"Autoimmune hemolytic anemia induced by anti-PD-1 therapy in metastatic melanoma","volume":"26","author":"Kong","year":"2016","journal-title":"Melanoma Res"},{"key":"2025042703254659000_2018.apr17_2.bcr-2018-224608.7","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s40425-017-0214-9","article-title":"Immunotherapy-associated autoimmune hemolytic anemia","volume":"5","author":"Khan","year":"2017","journal-title":"J Immunother Cancer"},{"key":"2025042703254659000_2018.apr17_2.bcr-2018-224608.8","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1159\/000452296","article-title":"Autoimmune hemolytic anemia as a complication of nivolumab therapy","volume":"9","author":"Palla","year":"2016","journal-title":"Case Rep Oncol"},{"key":"2025042703254659000_2018.apr17_2.bcr-2018-224608.9","doi-asserted-by":"crossref","unstructured":"Tardy MP , Gastaud L , Boscagli A , et al . 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