title: [Concomitant use of romiplostim and chemotherapy for advanced rectal cancer associated with idiopathic thrombocytopenic purpura].
abstract: A woman in her 60s was referred to our department with advanced rectal cancer and multiple unresectable metastases of the liver and peritoneum. She had been diagnosed with idiopathic thrombocytopenic purpura (ITP) in her 20s, with a platelet count maintained at approximately 1.0×10(4)/μL by prednisolone; on admission, her platelet count was 0.9×10(4)/μL. Romiplostim, a thrombopoietin receptor agonist, was administered prior to chemotherapy. Her platelet count increased to approximately 10.0×10(4)/μL during chemotherapy with oxaliplatin plus capecitabine, and she developed deep venous thrombosis requiring inferior vena cava filter placement and anticoagulation. No other severe adverse events occurred. There is no standard regimen for the treatment of solid tumors in patients with ITP. This is the first reported case of the concomitant use of romiplostim and chemotherapy for advanced rectal cancer. We believe that romiplostim can effectively salvage the platelet count in emergency situations such as during chemotherapy.
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine.
authors.forename: Moyuru
authors.initials: M
authors.lastname: Yamada
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Shinzaki
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nishida
authors.forename: Takuya
authors.initials: T
authors.lastname: Yamada
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Fujinaga
authors.forename: Takayuki
authors.initials: T
authors.lastname: Yakushijin
authors.forename: Tomohide
authors.initials: T
authors.lastname: Tatsumi
authors.forename: Hideki
authors.initials: H
authors.lastname: Iijima
authors.forename: Naoki
authors.initials: N
authors.lastname: Hiramatsu
authors.forename: Masahiko
authors.initials: M
authors.lastname: Tsujii
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Takehara
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000069287:Capecitabine; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000188:drug therapy*; D011961:Receptors, Fc / Q000008:administration & dosage*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D012004:Rectal Neoplasms / Q000150:complications / Q000188:drug therapy*; D013926:Thrombopoietin / Q000008:administration & dosage*
chemical_list: D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D011961:Receptors, Fc; D011993:Recombinant Fusion Proteins; D000077150:Oxaliplatin; D003841:Deoxycytidine; D000069287:Capecitabine; D013926:Thrombopoietin; C488777:romiplostim; D005472:Fluorouracil