Analysis of a case of thrombocytopenia induced by pralsetinib

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Author: Hao-Chun TANG ¹ Zheng-Zheng XIA ¹ Han YU ²  Jun MENG ¹

Affiliation: 1. National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, Guangdong Province, China 2. School of Pharmacy, Chongqing Medical University, Chongqing 400016, China

Keywords: Pralsetinib Thrombocytopenia Adverse drug reaction

DOI: 10.19960/j.issn.1005-0698.202308016

Reference: Hao-Chun TANG, Zheng-Zheng XIA, Han YU, Jun MENG.Analysis of a case of thrombocytopenia induced by pralsetinib[J].Yaowu Liuxingbingxue Zazhi,2023, 32(8):956-960.DOI: 10.19960/j.issn.1005-0698.202308016. [Article in Chinese]  Copied

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Abstract

In this paper, a case of a 58-year-old RET fusion of positive patient with advanced non-small cell lung cancer, who appeared grade 4 thrombocytopenia after receiving pralsetinib 400 mg qd regularly for anti-tumor therapy, was reported. Before the treatment, the patient's hemogram was normal. After continuous administration of pralsetinib for 27 days, the patient's platelet count (Plt) began to decrease dramatically, reaching the lowest level of 14×10⁹·L^-1. Even symptomatic treatment aimed at increasing platelet did not result in significant improvement. After conducting an adverse reaction causality assessment for thrombocytopenia, it was considered to be an adverse reaction induced by pralsetinib. Therefore, pralsetinib treatment was temporarily suspended and symptomatic treatment was given. Subsequently, the patient's condition gradually improved, and the Plt recovering to 94×10⁹·L^-1 10 days later . After the patient's hemogram gradually stabilized, the dosage of pralsetinib was adjusted to restart anti-tumor therapy. Clinical pharmacists determined that platinib-induced thrombocytopenia was likely to be caused by platinib through the association evaluation of adverse reactions, monitored the patient for symptomatic treatment, and proposed dosage adjustment suggestions for restarting platinib after the patient's Plt returned to normal. This case suggests that the clinical use of pratinib should be vigilant against thrombocytopenia adverse reactions, do a good job of pharmaceutical care, and timely drug analysis and symptomatic treatment after adverse reactions.

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References

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