CASE REPORT article
Front. Oncol.
Sec. Hematologic Malignancies
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1643313
Acute Obinutuzumab-Induced Thrombocytopenia in Follicular Lymphoma: Case Report and Literature Review
Provisionally accepted
- Department of Nuclear Radiation Injury Protection and Treatment Department, Naval Medical Center, Naval Medical University, Shanghai, China
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Introduction: Obinutuzumab, a type II anti-CD20 monoclonal antibody used in the treatment of follicular lymphoma, is associated with a higher incidence of adverse events, including thrombocytopenia, compared to Rituximab. We report a case of severe, acute thrombocytopenia induced by Obinutuzumab and explore its potential mechanism. Case Presentation: A 47-year-old woman with follicular lymphoma developed recurrent, severe (Grade III-IV) thrombocytopenia within 24 hours following Obinutuzumab administration, starting from her second treatment cycle. Subsequent bone marrow aspiration revealed significant megakaryocyte hyperplasia but with impaired platelet production. Key laboratory findings included elevated levels of pro-inflammatory cytokines TNF-α and IL-6, decreased complement levels, and reduced IgM, while platelet antibodies tested were negative. The patient's thrombocytopenia was managed and improved with treatments including recombinant human thrombopoietin(rhTPO), and platelet transfusions. Conclusion: Obinutuzumab can rarely cause acute, severe thrombocytopenia, possibly through a combination of immune-mediated platelet destruction and impaired megakaryocyte maturation.
Keywords: Obinutuzumab, Thrombocytopenia, Immune mechanism, follicular lymphoma, hematologic malignancies, case report
Received: 08 Jun 2025; Accepted: 15 Sep 2025.
Copyright: © 2025 Zhou, Zhang, Xu and Li. 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: Rong Li, 18558607350@163.com
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