Faculty Collaboration Database

Hypersensitivity reaction and acute immune-mediated thrombocytopenia from oxaliplatin: two case reports and a review of the literature. J Hematol Oncol 2010 Mar 26;3:12

Date

03/30/2010

Pubmed ID

20346128

Pubmed Central ID

PMC2859393

DOI

10.1186/1756-8722-3-12

Scopus ID

2-s2.0-77951606873 (requires institutional sign-in at Scopus site)   60 Citations

Abstract

BACKGROUND: 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.

CASE PRESENTATION: 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.

CONCLUSION: 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.

Author List

Bautista MA, Stevens WT, Chen CS, Curtis BR, Aster RH, Hsueh CT

Author

Brian Curtis PhD Director in the Platelet & Neutrophil Immunology Laboratory department at BloodCenter of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Antineoplastic Agents
Colorectal Neoplasms
Drug Hypersensitivity
Female
Humans
Lung Neoplasms
Male
Middle Aged
Organoplatinum Compounds
Purpura, Thrombocytopenic, Idiopathic