Department of Pathology and Laboratory Medicine, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.
J Hematol Oncol. 2010 Mar 26;3:12. doi: 10.1186/1756-8722-3-12.
Oxaliplatin is a platinum compound used in the treatment of gastrointestinal malignancies, including colorectal cancer. The incidence of hypersensitivity reaction in patients receiving oxaliplatin is approximately 15%, with severe reaction (grade 3 and 4) occurring in 2% of patients.
We report two patients with metastatic colorectal cancer who developed de novo hypersensitivity reaction and acute thrombocytopenia after oxaliplatin infusion. Both patients had oxaliplatin treatment several years before and exhibited hypersensitivity on the third dose of oxaliplatin in recent treatment. Oxaliplatin was discontinued when clinical reaction was identified. Both patients were confirmed to have strong oxaliplatin-induced IgG platelet-reactive antibodies. Both patients' thrombocytopenia resolved within two weeks after discontinuation of oxaliplatin. One patient had disease stabilization lasting for three months without chemotherapy. Both patients subsequently received other chemotherapeutic agents without evidence of hypersensitivity reaction or immune-mediated thrombocytopenia.
We recommend vigilant monitoring of complete blood count and signs and symptoms of bleeding after the occurrence of oxaliplatin-induced hypersensitivity to avoid serious complications of immune-mediated thrombocytopenia.
奥沙利铂是一种用于治疗胃肠道恶性肿瘤（包括结直肠癌）的铂类化合物。接受奥沙利铂治疗的患者发生过敏反应的发生率约为 15%，其中 2%的患者出现严重反应（3 级和 4 级）。
我们报告了两名转移性结直肠癌患者，他们在奥沙利铂输注后出现新的过敏反应和急性血小板减少症。这两名患者均在几年前接受过奥沙利铂治疗，最近治疗中第三剂奥沙利铂时出现过敏反应。当临床出现反应时，奥沙利铂被停用。两名患者均被证实有强烈的奥沙利铂诱导的 IgG 血小板反应性抗体。奥沙利铂停用后两周内，两名患者的血小板减少均得到缓解。一名患者在无化疗的情况下疾病稳定持续三个月。两名患者随后接受了其他化疗药物治疗，未出现过敏反应或免疫介导性血小板减少症的证据。
我们建议在发生奥沙利铂诱导的过敏反应后密切监测全血细胞计数和出血迹象及症状，以避免免疫介导性血小板减少症的严重并发症。
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