免疫检查点抑制剂（ICIs）在肺癌治疗中展现出独特的优势，在免疫治疗时代得到广泛应用。然而，ICIs 可能会引起不良反应。免疫治疗引起的血液学毒性相对罕见。粒细胞缺乏症是一种与免疫检查点抑制剂相关的罕见血液学不良事件，在治疗和患者人口统计方面受到的关注有限。在此，我们报告一例患有非小细胞肺癌（NSCLC）的68岁男性，接受两个周期的程序性细胞死亡-1（PD-1）抗体信迪利单抗免疫治疗联合白蛋白结合紫杉醇和卡铂的病例化疗和一个周期的信迪利单抗单药治疗。在前两个周期的治疗后，他被诊断患有 4 级中性粒细胞减少症和败血症（伴有发烧和寒战症状）。替考拉宁立即开始作为抗菌治疗。患者在第三个周期治疗开始当天突然出现高烧，并出现粒细胞缺乏症，中性粒细胞绝对计数为0.0×109/L。该患者接受了粒细胞集落刺激因子治疗，但没有显示出改善。随后，他接受了皮质类固醇治疗，中性粒细胞绝对计数逐渐恢复到正常水平。据我们所知，这是首例报告的 NSCLC 患者中信迪利单抗诱导的粒细胞缺乏症病例。信迪利单抗引起的严重中性粒细胞减少症或粒细胞缺乏症是一种罕见的副作用，应与化疗引起的中性粒细胞减少症区别开来，并及时采用适当的疗法进行治疗；否则，病情可能会恶化。版权所有 © 2024 秦、陆、陈、彭、杨。

Immune checkpoint inhibitors (ICIs) demonstrate unique advantages in the treatment of lung cancer and are widely used in the era of immunotherapy. However, ICIs can cause adverse reactions. Hematological toxicities induced by immunotherapy are relatively rare. Agranulocytosis, a rare hematologic adverse event associated with immune checkpoint inhibitors, has received limited attention in terms of treatment and patient demographics. Herein, we report the case of a 68-year-old male with non-small cell lung cancer(NSCLC) who received two cycles of programmed cell death-1 (PD-1) antibody sintilimab immunotherapy combined with albumin-bound paclitaxel and carboplatin chemotherapy and one cycle of sintilimab monotherapy. He was diagnosed with grade 4 neutropenia and sepsis (with symptoms of fever and chills) after the first two cycles of treatment. Teicoplanin was promptly initiated as antimicrobial therapy. The patient presented with sudden high fever and developed agranulocytosis on the day of the third cycle of treatment initiation, characterized by an absolute neutrophil count of 0.0×109/L. The patient was treated with granulocyte colony-stimulating factor but did not show improvement. He was then treated with corticosteroids, and absolute neutrophil counts gradually returned to normal levels. To the best of our knowledge, this is the first reported case of sintilimab-induced agranulocytosis in a patient with NSCLC. Sintilimab-induced severe neutropenia or agranulocytosis is a rare side effect that should be distinguished from chemotherapy-induced neutropenia and treated promptly with appropriate therapies; otherwise, the condition may worsen.Copyright © 2024 Qin, Lu, Chen, Peng and Yang.