title: Oxaliplatin-induced immune pancytopenia.
abstract: BACKGROUND
  Oxaliplatin, a third-generation platinum compound, has been implicated in isolated cases of immune hemolytic anemia and/or immune thrombocytopenia. The first case of severe immune pancytopenia related to oxaliplatin is described.
  
  
  METHODS
  A 79-year-old woman with colorectal cancer was initially treated with 5-fluorouracil and she later received oxaliplatin and leucovorin every 2 to 4 weeks. During the 15th and 17th cycles of chemotherapy she developed thrombocytopenia, hemolysis, and neutropenia. No problems occurred during the 16th cycle without oxaliplatin. Serologic testing including detection of drug-dependent antibodies and autoantibodies was performed with standard techniques.
  
  
  RESULTS
  Serologic findings included a positive immunoglobulin G direct antiglobulin test; nonreactive red blood cell (RBC) eluates; platelet (PLT)-bound antibodies to glycophorin (GP) IIb-IIIa, GPIb-IX, and GPIa-IIa; and oxaliplatin-dependent antibodies to PLTs, RBCs, and neutrophils.
  
  
  CONCLUSIONS
  Oxaliplatin may lead to the production of ddabs to RBCs, PLTs, and neutrophils. Thus the risk of immune cytopenias should always be considered in patients treated with oxaliplatin.
authors.affiliation: Department of Hematology and Central Hematology Laboratory, Division of Transfusion Medicine, University Hospital, Inselspital, Bern, Switzerland.
authors.forename: Behrouz Mansouri
authors.initials: BM
authors.lastname: Taleghani
authors.forename: Oliver
authors.initials: O
authors.lastname: Meyer
authors.forename: Stefano
authors.initials: S
authors.lastname: Fontana
authors.forename: Norbert
authors.initials: N
authors.lastname: Ahrens
authors.forename: Urban
authors.initials: U
authors.lastname: Novak
authors.forename: Markus M
authors.initials: MM
authors.lastname: Borner
authors.forename: Abdulgabar
authors.initials: A
authors.lastname: Salama
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D005260:Female; D006461:Hemolysis; D006801:Humans; D009503:Neutropenia / Q000139:chemically induced / Q000276:immunology; D009944:Organoplatinum Compounds / Q000009:adverse effects*; D000077150:Oxaliplatin; D010198:Pancytopenia / Q000139:chemically induced* / Q000276:immunology; D013921:Thrombocytopenia / Q000139:chemically induced / Q000276:immunology
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin