CASE REPORT article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1672282
This article is part of the Research TopicImmunology and Immunotherapy of Skin CancerView all 17 articles
Severe neutropenia induced by avelumab in a patient with Merkel cell carcinoma
Provisionally accepted
- University of Occupational and Environmental Health Japan, Kitakyushu, Japan
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A 78-year-old woman with a history of follicular lymphoma treated with obinutuzumab and bendamustine developed Merkel cell carcinoma (MCC) on her left forearm. After surgical excision, in-transit and lymph node metastases appeared within three weeks. Avelumab and radiotherapy were initiated, but severe neutropenia occurred after two doses, requiring G-CSF support and treatment discontinuation. Despite early cessation, metastatic lesions regressed. This case suggests that prior B-cell–directed therapy may increase the risk of hematologic toxicity with immune checkpoint inhibitors and that even short-term avelumab may induce a durable response in MCC.
Keywords: avelumab, case report, merkel cell carcinoma, Neutropenia, irAE
Received: 24 Jul 2025; Accepted: 26 Sep 2025.
Copyright: © 2025 Ohta, Yamamoto, Fujimura, Saito-Sasaki, Okada and Sawada. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yu Sawada, long-ago@med.uoeh-u.ac.jp
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