Oxaliplatin-induced acute-onset thrombocytopenia, hemorrhage and hemolysis.
BACKGROUND
Oxaliplatin is a novel platinum derivative with established anti-tumor activity in colorectal cancer. Acute-onset hemolytic anemia and thrombocytopenia associated with this drug have rarely been reported and some of these cases have been severe or even fatal.


METHODS
This case report describes a patient who developed fever, chills, abdominal and back pain as well as sudden-onset severe thrombocytopenia, upper gastrointestinal bleeding and hemolysis immediately after treatment with oxaliplatin for metastatic colorectal cancer. The reaction appeared during the 14th cycle of chemotherapy. Corticosteroids and antihistamines were administered together with platelet transfusions. Over the next 2 days platelet count improved and the syndrome abated. The patient was discharged 4 days later. Furthermore, the reaction was accompanied by a strongly positive Coombs test and increased TNF-alpha and IL-10 serum levels which returned to normal following anti-inflammatory drug administration.


CONCLUSIONS
Physicians should be aware of the possibility of acute hematological emergencies following oxaliplatin administration.
Koutras
A K
AK
Division of Oncology, Department of Medicine, University Hospital, Patras Medical School, Rion, Greece.
Makatsoris
T
T
Paliogianni
F
F
Kopsida
G
G
Onyenadum
A
A
Gogos
C A
CA
Mouzaki
A
A
Kalofonos
H P
HP
D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000473:pathology; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000628:therapy; D006461:Hemolysis / Q000187:drug effects*; D006634:Histamine H1 Antagonists / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D000077150:Oxaliplatin; D010976:Platelet Count; D017713:Platelet Transfusion; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000628:therapy
D000305:Adrenal Cortex Hormones; D000970:Antineoplastic Agents; D006634:Histamine H1 Antagonists; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin