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一名胰腺癌患者出现奥沙利铂诱导的免疫性血小板减少症。

Oxaliplatin-Induced Immune Thrombocytopenia in a Patient with Pancreatic Cancer.

作者信息

Şentürk Mustafa, Altundağ Özden

机构信息

Department of Internal Medicine, Başkent University Faculty of Medicine, Ankara, Turkey.

Department of Medical Oncology, Başkent University Faculty of Medicine, Ankara, Turkey.

出版信息

Eur J Case Rep Intern Med. 2024 Aug 21;11(9):004782. doi: 10.12890/2024_004782. eCollection 2024.

Abstract

UNLABELLED

Oxaliplatin-induced immune thrombocytopenia is a rare but potentially serious complication of chemotherapy. We present the case of a 55-year-old man with stage 4 pancreatic carcinoma who developed immune thrombocytopenia during the 18 cycle of folinic acid, fluorouracil, irinotecan, and oxaliplatin (FOLFIRINOX) chemotherapy, immediately after oxaliplatin infusion. Despite treatment with methylprednisolone and platelet infusion, the patient's platelet count remained low. Subsequent plasmapheresis and continued steroid therapy resulted in a gradual improvement in platelet count and resolution of symptoms. This case highlights the importance of considering immune thrombocytopenia in patients receiving oxaliplatin-based chemotherapy, and the potential role of plasmapheresis in refractory cases. Further research is needed to elucidate the optimal management of this rare complication.

LEARNING POINTS

Oxaliplatin-induced immune thrombocytopenia is a rare but potentially life-threatening side effect of chemotherapy.Management of drug-induced immune thrombocytopenia involves discontinuation of the offending drug and the use of steroids.Monitoring and follow-up are crucial in patients receiving oxaliplatin-based chemotherapy to promptly detect and manage potential hematologic emergencies, including immune thrombocytopenia.

摘要

未标注

奥沙利铂诱导的免疫性血小板减少症是化疗一种罕见但潜在严重的并发症。我们报告一例55岁的4期胰腺癌男性患者,在接受亚叶酸、氟尿嘧啶、伊立替康和奥沙利铂(FOLFIRINOX)化疗的第18个周期,在输注奥沙利铂后立即出现免疫性血小板减少症。尽管使用了甲泼尼龙和输注血小板治疗,但患者的血小板计数仍维持在低水平。随后的血浆置换和持续的类固醇治疗使血小板计数逐渐改善,症状得以缓解。该病例强调了在接受基于奥沙利铂化疗的患者中考虑免疫性血小板减少症的重要性,以及血浆置换在难治性病例中的潜在作用。需要进一步研究以阐明这种罕见并发症的最佳管理方法。

学习要点

奥沙利铂诱导的免疫性血小板减少症是化疗一种罕见但潜在危及生命的副作用。药物诱导的免疫性血小板减少症的管理包括停用致病药物和使用类固醇。对接受基于奥沙利铂化疗的患者进行监测和随访对于及时发现和处理潜在的血液学紧急情况(包括免疫性血小板减少症)至关重要。

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本文引用的文献

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Oxaliplatin-induced immune mediated thrombocytopenia.奥沙利铂诱导的免疫介导性血小板减少症。
Cancer Chemother Pharmacol. 2008 Oct;62(5):925-7. doi: 10.1007/s00280-007-0675-5. Epub 2008 Jan 19.
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Oxaliplatin-induced immune pancytopenia.奥沙利铂诱导的免疫性全血细胞减少症。
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