Drug-Induced Megaloblastic Anemia

Abstract

To the Editor: In their review article, Hesdorffer and Longo (Oct. 22 issue)¹ analyze the causes of drug-related megaloblastic anemia, describing the biochemical processes and the most common drugs involved. To our knowledge, sunitinib, a multitargeted tyrosine kinase inhibitor that has been approved for the treatment of metastatic renal-cell carcinoma and gastrointestinal stromal tumor, can also induce macrocytosis and subsequent anemia.

Rini et al.² found a correlation between macrocytosis and sunitinib-based treatment. Similar results were obtained by Price et al.³ in a review of 43 patients who had been treated with sunitinib; macrocytosis developed in 49% of those patients, and . . .