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Leucopenia, thrombocytopenia and skin rash: case report A 47-year-old woman developed grade 4 thrombocytopenia, grade 4 leucopenia and grade 2 skin rash during treatment with camrelizumab, doxorubicin and cisplatin for pulmonary sarcomatoid carcinoma (PSC) [not all routes stated; durations of treatment to reactions onset not stated]. The woman, who was a nonsmoker, was admitted to hospital in March 2018 at the age of 47 years due to on month history of chest pain and haemoptysis. She had undergone a radical resection of neurofibrosarcoma in her left thigh and postoperative chemoradiotherapy 18 years prior without any local recurrence. The clinical findings and imaging studies on admission were suggestive of primary PSC Stage IIIB cT4N2M0. She started receiving first line treatment with IV camrelizumab 200mg once every two weeks along with doxorubicin 40 mg/m2 of body surface area and cisplatin 75 mg/m2 of body surface area, respectively every three weeks in April 2018. The treatment was scheduled to be continued until disease progression or intolerable adverse events. In July 2018 following three cycles of chemotherapy, lesions in the right lower and upper lobes indicated a partial remission. After six cycles of camrelizumab and four cycles of cisplatin and doxorubicin, the tumour in right lower lobe indicated complete remission and the lesion in the upper lobe indicated partial response. She developed grade 4 leucopenia, grade 4 thrombocytopenia and grade 2 skin rashes attributed to the therapy. The woman’s treatment with camrelizumab, doxorubicin and cisplatin was discontinued. She received supportive care, piperacillin/sulbactam, platelet transfusion and unspecified granulocyte colony-stimulating factor which required hospitalisation. The haematologic toxicity including leucopenia and thrombocytopenia was controlled gradually within one month. Two months following the treatment discontinuation, her rashes resolved spontaneously. Rechallenge with camrelizumab was initiated at the same dose for another six cycles and no grade 3 or 4 adverse events were noted. Twenty months follow-up revealed a durable response of her intrathoracic lesions. Kong F, et al. Anti-PD-1 antibody camrelizumab plus doxorubicin showed durable response in pulmonary sarcomatoid carcinoma: Case report and literature review. Journal of 803499881 Clinical Pharmacy and Therapeutics : no pagination, 10 Aug 2020. Available from: URL: http://doi.org/10.1111/jcpt.13234

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