ArticleFrontiers in oncology2026
Case Report: From complete remission to severe anemia: pure red cell aplasia emerged after VRd regimen in multiple myeloma.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Pure red cell aplasia (PRCA) is a rare disorder characterized by severe reticulocytopenia and absence of erythroid precursors. Its association with multiple myeloma (MM) therapy is uncommon. We report a 73-year-old man with MM (IgGλ, stage IIIA) who achieved complete remission after five cycles of VRd (bortezomib, lenalidomide, dexamethasone). During lenalidomide maintenance, he developed severe anemia (hemoglobin 45 g/L, reticulocytes 0.01%). Bone marrow biopsy showed absent erythroid precursors with preserved granulocytic and megakaryocytic lineages, consistent with PRCA. Following discontinuation of lenalidomide, cyclosporine therapy increased hemoglobin to 92 g/L within one month. This case highlights that PRCA can occur after MM treatment and underscores the importance of early detection by monitoring reticulocytes. A comprehensive approach including withdrawal of offending agents and immunosuppressive therapy is critical.
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