title: Long-term control of bone marrow carcinosis and severe thrombocytopenia with standard-dose chemotherapy in a breast cancer patient: a case report.
abstract: BACKGROUND
  Primary metastatic breast cancer with bone marrow involvement and pronounced thrombocytopenia is rare. The myelosuppressive effect of most cytotoxic drugs limits chemotherapy in patients with cytopenia due to marrow involvement.
  
  
  METHODS
  A 62-year-old patient, who presented with locally and systemically advanced breast cancer, is reported. The initial work-up revealed bone marrow carcinosis with thrombocytopenia of less than 20,000/mm3 lung and osseous metastases without signs of suppressed erythropoiesis and leucopoiesis. The patient was stabilized with 6 different standard-dose chemotherapy regimens, antihormonal therapy, and trastuzumab before dying 57 months after first diagnosis. The patient received only platelet transfusions on 2 instances with platelets of 2,000/mm3.
  
  
  CONCLUSIONS
  This case illustrates that aggressive standard chemotherapy may be feasible in selected patients with bone marrow carcinosis-associated thrombocytopenia without major bleeding episodes.
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria. vesna.bjelic-radisic@klinikum-graz.at
authors.forename: V
authors.initials: V
authors.lastname: Bjelic-Radisic
authors.forename: H
authors.initials: H
authors.lastname: Stöger
authors.forename: R
authors.initials: R
authors.lastname: Winter
authors.forename: C
authors.initials: C
authors.lastname: Beham-Schmid
authors.forename: E
authors.initials: E
authors.lastname: Petru
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001853:Bone Marrow / Q000473:pathology; D001943:Breast Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D013921:Thrombocytopenia / Q000150:complications* / Q000473:pathology