Document Detail

Sudden-onset pancytopenia with intracranial hemorrhage after oxaliplatin treatment: a case report and literature review.
MedLine Citation:
PMID:  20826449     Owner:  NLM     Status:  MEDLINE    
Oxaliplatin is a third-generation platinum compound and has been widely employed in the treatment of colorectal cancer. Despite its good efficacy, it is reported to induce immune-mediated cytopenia. We report the case of a 78-year-old male patient who experienced acute pancytopenia along with coagulopathy and intracranial hemorrhage after his 17th course of oxaliplatin. This condition appeared immediately after completion of oxaliplatin infusion, and was persistent despite aggressive transfusion and treatment with granulocyte colony-stimulating factor. The patient died 72 h after the administration of oxaliplatin. The only preceding symptom was chills 30 min after initiation of oxaliplatin, although steroid was given as premedication. We review the literature describing oxaliplatin-induced cytopenia, and discuss the manifestation, immune mechanism and treatment of this condition. We conclude that any symptoms that occur during infusion of oxaliplatin should not be overlooked but should be taken seriously as they may represent 'a little spark that kindles a great fire', and that steroids may provide an effective treatment for oxaliplatin-induced cytopenia. However, a major complication in our patient may still happen. Further studies for the mechanism and the predictive markers of oxaliplatin-induced cytopenia are worthy.
Chung-Jen Teng; Yao-Yu Hsieh; Kuo-Wei Chen; Ta-Chung Chao; Cheng-Hwai Tzeng; Wei-Shu Wang
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Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2010-09-07
Journal Detail:
Title:  Japanese journal of clinical oncology     Volume:  41     ISSN:  1465-3621     ISO Abbreviation:  Jpn. J. Clin. Oncol.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-03     Completed Date:  2011-01-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0313225     Medline TA:  Jpn J Clin Oncol     Country:  England    
Other Details:
Languages:  eng     Pagination:  125-9     Citation Subset:  IM    
Division of Oncology and Hematology, Department of Medicine, National Yang-Ming University Hospital, Yilan, Taiwan.
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MeSH Terms
Acute Disease
Adenocarcinoma / drug therapy,  secondary
Antineoplastic Agents / administration & dosage,  adverse effects*
Cerebral Hemorrhage / chemically induced*,  radiography,  therapy
Fatal Outcome
Liver Neoplasms / drug therapy,  secondary
Organoplatinum Compounds / administration & dosage,  adverse effects*
Pancytopenia / chemically induced*,  therapy
Sigmoid Neoplasms / drug therapy,  pathology
Subarachnoid Hemorrhage / chemically induced*,  radiography,  therapy
Tomography, X-Ray Computed
Reg. No./Substance:
0/Antineoplastic Agents; 0/Organoplatinum Compounds; 63121-00-6/oxaliplatin

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