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Acute Immune-Mediated Thrombocytopenia due to Oxaliplatin and Irinotecan Therapy

We describe a case of a 63-year-old woman with advanced colon cancer and liver metastases who was treated with fluorouracil, leucovorin, and oxaliplatin (FOLFOX) and cetuximab chemotherapy. She tolerated 13 cycles of chemotherapy without any significant hematological side effects, but after the 14th...

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Autores principales: Tam, Eric L., Draksharam, Padma L., Park, Jennifer A., Sidhu, Gurinder S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875012/
https://www.ncbi.nlm.nih.gov/pubmed/31781443
http://dx.doi.org/10.1155/2019/4314797
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author Tam, Eric L.
Draksharam, Padma L.
Park, Jennifer A.
Sidhu, Gurinder S.
author_facet Tam, Eric L.
Draksharam, Padma L.
Park, Jennifer A.
Sidhu, Gurinder S.
author_sort Tam, Eric L.
collection PubMed
description We describe a case of a 63-year-old woman with advanced colon cancer and liver metastases who was treated with fluorouracil, leucovorin, and oxaliplatin (FOLFOX) and cetuximab chemotherapy. She tolerated 13 cycles of chemotherapy without any significant hematological side effects, but after the 14th cycle, she developed melena and was admitted for severe thrombocytopenia. After supportive care, the platelet counts rapidly improved to 76,000/μL. Upon initiation of FOLFIRI and cetuximab chemotherapy, she again developed rectal bleeding and severe thrombocytopenia with a platelet count of 6000/μL. Lab testing was positive for oxaliplatin and irinotecan drug-dependent platelet antibodies on flow cytometry assay. Drug-induced thrombocytopenia (DITP) is associated with several classes of drugs with several proposed underlying mechanisms. Prospective studies are needed to further address different mechanisms of drug-induced thrombocytopenia.
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spelling pubmed-68750122019-11-28 Acute Immune-Mediated Thrombocytopenia due to Oxaliplatin and Irinotecan Therapy Tam, Eric L. Draksharam, Padma L. Park, Jennifer A. Sidhu, Gurinder S. Case Rep Oncol Med Case Report We describe a case of a 63-year-old woman with advanced colon cancer and liver metastases who was treated with fluorouracil, leucovorin, and oxaliplatin (FOLFOX) and cetuximab chemotherapy. She tolerated 13 cycles of chemotherapy without any significant hematological side effects, but after the 14th cycle, she developed melena and was admitted for severe thrombocytopenia. After supportive care, the platelet counts rapidly improved to 76,000/μL. Upon initiation of FOLFIRI and cetuximab chemotherapy, she again developed rectal bleeding and severe thrombocytopenia with a platelet count of 6000/μL. Lab testing was positive for oxaliplatin and irinotecan drug-dependent platelet antibodies on flow cytometry assay. Drug-induced thrombocytopenia (DITP) is associated with several classes of drugs with several proposed underlying mechanisms. Prospective studies are needed to further address different mechanisms of drug-induced thrombocytopenia. Hindawi 2019-11-04 /pmc/articles/PMC6875012/ /pubmed/31781443 http://dx.doi.org/10.1155/2019/4314797 Text en Copyright © 2019 Eric L. Tam et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Tam, Eric L.
Draksharam, Padma L.
Park, Jennifer A.
Sidhu, Gurinder S.
Acute Immune-Mediated Thrombocytopenia due to Oxaliplatin and Irinotecan Therapy
title Acute Immune-Mediated Thrombocytopenia due to Oxaliplatin and Irinotecan Therapy
title_full Acute Immune-Mediated Thrombocytopenia due to Oxaliplatin and Irinotecan Therapy
title_fullStr Acute Immune-Mediated Thrombocytopenia due to Oxaliplatin and Irinotecan Therapy
title_full_unstemmed Acute Immune-Mediated Thrombocytopenia due to Oxaliplatin and Irinotecan Therapy
title_short Acute Immune-Mediated Thrombocytopenia due to Oxaliplatin and Irinotecan Therapy
title_sort acute immune-mediated thrombocytopenia due to oxaliplatin and irinotecan therapy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875012/
https://www.ncbi.nlm.nih.gov/pubmed/31781443
http://dx.doi.org/10.1155/2019/4314797
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