Department of Nephrology, Chinese PLA Strategic Support Force Medical Center, Beijing, p.R. China.
Hemodial Int. 2022 Jul;26(3):E31-E36. doi: 10.1111/hdi.13020. Epub 2022 May 18.
A 69-year-old woman under maintenance hemodialysis was diagnosed with advanced ovarian cancer. We treated the patient with combination chemotherapy using paclitaxel and carboplatin. She experienced grade 4 thrombopenia on day 8 of the third course. The area under the concentration versus time curve (AUC) of platinum was 3.5 mg/ml·min. The interval between chemotherapy and hemodialysis was shortened starting with the fourth course. The AUC of platinum was then found to be 1.8 mg/ml·min. After seven courses of chemotherapy, the patient's CA 125 serum level dropped from 1317 to 42.6 U/ml. Nevertheless, the patient presented with long periods of severe myelosuppression. In patients on hemodialysis receiving such chemotherapy, the AUC of each cycle should be closely monitored and the dialysis schedule should be adjusted as need to reduce the risk of bone marrow suppression.
一位 69 岁女性在维持性血液透析下被诊断为晚期卵巢癌。我们使用紫杉醇和卡铂对患者进行联合化疗。她在第三个疗程的第 8 天出现 4 级血小板减少症。铂的浓度-时间曲线下面积（AUC）为 3.5mg/ml·min。从第四个疗程开始，化疗和血液透析之间的间隔缩短。随后发现铂的 AUC 为 1.8mg/ml·min。七轮化疗后，患者的 CA 125 血清水平从 1317 降至 42.6U/ml。然而，患者出现了长时间的严重骨髓抑制。在接受此类化疗的血液透析患者中，应密切监测每个周期的 AUC，并根据需要调整透析方案，以降低骨髓抑制的风险。
