{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:12:23Z","timestamp":1790683943867,"version":"4.1.0"},"reference-count":19,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Rep Oncol"],"abstract":"<jats:p>Introduction: Hematological immune-related adverse events associated with immune checkpoint inhibitors (ICIs) are rare, and autoimmune hemolytic anemia (AIHA) is particularly uncommon. Case Presentation: A 71-year-old woman with stage IIA triple-negative breast cancer received perioperative pembrolizumab with carboplatin and paclitaxel. During the first treatment cycle, she developed acute severe anemia with laboratory findings consistent with hemolysis. Despite a negative direct antiglobulin test (DAT), major alternative causes of hemolysis were considered unlikely, leading to a clinical diagnosis of suspected ICI-associated AIHA. Oral prednisolone (1 mg\/kg) promptly resolved hemolysis without recurrence. Pembrolizumab was discontinued; however, imaging demonstrated a clinical complete response, and subsequent surgery confirmed a pathological complete response (pCR). Conclusion: This case demonstrates that AIHA during ICI therapy may occur despite a negative DAT and underscores the importance of prompt recognition and corticosteroid therapy. Favorable oncologic outcomes, including pCR, may still be achieved despite early discontinuation of ICI therapy.<\/jats:p>","DOI":"10.1159\/000552991","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T16:01:29Z","timestamp":1782144089000},"page":"1100-1107","source":"Crossref","is-referenced-by-count":1,"title":["Early-Onset Direct Antiglobulin Test-Negative Autoimmune Hemolytic Anemia Induced by Pembrolizumab in Perioperative Triple-Negative Breast Cancer: A Case Report"],"prefix":"10.1159","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7004-9889","authenticated-orcid":false,"given":"Ryohei","family":"Fujii","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8647-5098","authenticated-orcid":false,"given":"Nobuhiro","family":"Shibata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Kikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Fujita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8041-0074","authenticated-orcid":false,"given":"Yuri","family":"Noda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikiko","family":"Kasahara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8961-4220","authenticated-orcid":false,"given":"Chie","family":"Hirai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manami","family":"Tada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotsugu","family":"Yanai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoharu","family":"Sugie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Takada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2016.66"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2409932"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13187"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(18)30175-3"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2018-0574"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2021.11.002"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1586426"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25448"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.00946"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1186\/s12979-020-00208-7"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-024-00566-2"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s10637-026-01596-1"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.27339"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14478"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.77.6385"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.41.0902"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30904-X"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2021.07.007"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1097\/PAI.0000000000001125"}],"container-title":["Case Reports in Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000552991","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:01:05Z","timestamp":1785772865000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000552991"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000552991","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.32740311","asserted-by":"subject"}]},"ISSN":["1662-6575"],"issn-type":[{"value":"1662-6575","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,22]]}}}