Niraparib-induced pure red cell aplasia

Introduction Niraparib, a strong poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitor, contributed significantly to progression-free survival as a maintenance therapy in the platinum-sensitive period in both first-line and recurrent ovarian cancer, regardless of the BRCA mutation. Grade 3–...

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Published in:	Journal of oncology pharmacy practice Vol. 30; no. 1; pp. 210 - 214
Main Authors:	Bir Yücel, Kadriye, Yıldız, Seyma, Sütcüoglu, Osman, Güvercin, Fatma Sena, Uyar Göçün, Pınar, Özdemir, Nuriye, Yazıcı, Ozan, Özet, Ahmet
Format:	Journal Article
Language:	English
Published:	London, England SAGE Publications 01-01-2024 Sage Publications Ltd
Subjects:	Aged Anemia Anemia, Refractory - chemically induced Anemia, Refractory - drug therapy Aplasia Biopsy Breast cancer Erythrocytes Female Hemoglobin Humans Indazoles Neoplasm Recurrence, Local - drug therapy Ovarian cancer Ovarian Neoplasms - drug therapy Piperidines Poly(ADP-ribose) Polymerase Inhibitors - adverse effects Prednisolone Red-Cell Aplasia, Pure - chemically induced Red-Cell Aplasia, Pure - drug therapy Refractory anemia Steroids Steroids - therapeutic use Anemia ovarian cancer pure red cell aplasia niraparib steroid
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Summary:	Introduction Niraparib, a strong poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitor, contributed significantly to progression-free survival as a maintenance therapy in the platinum-sensitive period in both first-line and recurrent ovarian cancer, regardless of the BRCA mutation. Grade 3–4 anemia, which has a manageable side effect profile, especially hematological, is seen in almost 1 out of every 4 patients. To the best of our knowledge, there has been no reported case of pure red cell aplasia (PRCA) induced by niraparib treatment. Case Report A 65-year-old woman diagnosed with stage 3 serous carcinoma of the tuba received niraparib front-line maintenance treatment had grade 4 anemia after 3 months of niraparib treatment. She underwent bone marrow aspiration and biopsy because of refractory anemia, which needs red blood cell (RBC) transfusions despite interruption of treatment. Management and Outcome The patient was treated with 1 mg/kg methyl prednisolone, after histopathological assessment was consistent with PRCA. The hemoglobin count returned to the normal range with steroid treatment. Discussion In daily practice, it should be kept in mind that in the case of refractory anemia induced by niraparib, the underlying cause might be PRCA and can be improved with steroid administration.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	1078-1552 1477-092X
DOI:	10.1177/10781552231197808