Aplastic anemia following administration of a tumor necrosis factor-alpha inhibitor

Eur J Haematol. 2003 Nov;71(5):396-8. doi: 10.1034/j.1600-0609.2003.00115.x.


Upregulation of tumor necrosis factor-alpha (TNF-alpha) has been implicated in the pathogenesis of several inflammatory conditions, including rheumatoid arthritis. Therapeutic agents such as antibodies or soluble TNF-alpha receptor analogs, which block TNF-alpha activity are a recent addition to the therapeutic armamentarium for the conditions. We describe a patient who developed aplastic anemia complicated by sepsis after receiving etanercept, a TNF-alpha receptor analog, for the treatment of rheumatoid arthritis. Pancytopenia resolved within 3 wk of discontinuing etanercept. To our knowledge, this is the first report of aplastic anemia associated with TNF-alpha blockade.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anemia, Aplastic / chemically induced*
  • Arthritis, Rheumatoid / drug therapy
  • Drug Therapy, Combination
  • Etanercept
  • Humans
  • Immunoglobulin G / adverse effects*
  • Immunoglobulin G / pharmacology
  • Immunoglobulin G / therapeutic use
  • Male
  • Methotrexate / therapeutic use
  • Receptors, Tumor Necrosis Factor / therapeutic use
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*


  • Immunoglobulin G
  • Receptors, Tumor Necrosis Factor
  • Tumor Necrosis Factor-alpha
  • Etanercept
  • Methotrexate