Acute hemolysis after receiving oxaliplatin treatment: a case report and literature review.
OBJECTIVE
To report a case of immune mediated hemolysis occurring after oxaliplatin infusion in a patient with rectal cancer.


METHODS
We report a 69 year old male patient who presented with acute onset anemia after infusion of oxaliplatin as chemotherapy. A positive direct Coombs test and good response to steroids treatment underlined the diagnosis of immune related hemolytic anemia. The patient was switched to irinotecan-based chemotherapy regimen for further treatment.


CONCLUSIONS
To our knowledge, there has been less than 10 cases of hemolysis occurring after oxaliplatin treatment in the medical literature. In all cases, immune mediated hemolysis has been proven with a positive coombs test. As oxaliplatin based chemotherapy regimen has become a standardized first line treatment for metastatic colorectal adenocarcinoma, this phenomenon warrants a higher level of physician awareness.


CONCLUSIONS
Oxaliplatin related hemolytic anemia is a rare reported phenomenon. Patient under oxaliplatin treatment presenting with sudden hemoglobin decrease should prompt further investigation of hemolysis.
Lai
Jiun-I
JI
Department of Medicine, National Yang-Ming University Hospital, Yilan, Taiwan.
Wang
Wei-Shu
WS
Department of Medicine, National Yang-Ming University Hospital, Yilan, Taiwan. 11313@ymuh.ym.edu.tw.|National Yang-Ming University School of Medicine, National Yang-Ming University Hospital, No. 152, Xin-Min Road, Yilan, 26042, Taiwan. 11313@ymuh.ym.edu.tw.
D000208:Acute Disease; D000368:Aged; D000743:Anemia, Hemolytic / Q000139:chemically induced* / Q000175:diagnosis*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D006461:Hemolysis / Q000187:drug effects; D006801:Humans; D008297:Male; D009944:Organoplatinum Compounds / Q000009:adverse effects*; D000077150:Oxaliplatin
D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin