Frederick G. Dold, MD; Edith P. Mitchell, MD
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Dold FG, Mitchell EP. Sudden-Onset Thrombocytopenia with Oxaliplatin. Ann Intern Med. 2003;139:W-59. doi: 10.7326/0003-4819-139-2-200307150-00021-w3
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Published: Ann Intern Med. 2003;139(2):W-59.
TO THE EDITOR:
Background: Oxaliplatin is a third-generation platinum compound that has shown activity in colorectal cancer. Although it has been used for several years in Europe, it has been approved for use in the United States only since 9 August 2002. With this approval, widespread use is anticipated. Two previous published reports described thrombocytopenia and hemolytic anemia thought to be caused by oxaliplatin (1, 2).
Objective: To describe a case of sudden-onset thrombocytopenia in a patient taking oxaliplatin.
Case Report: In June 2002, a 70-year-old woman with colon cancer metastatic to the liver presented for her 19th cycle of oxaliplatin. Blood drawn before chemotherapy showed a hemoglobin level of 97 g/L and a platelet count of 432 × 109 cells/L. The patient received a 5-mL heparin flush through her port, and oxaliplatin, 85 mg/m2. After approximately three quarters of the oxaliplatin infusion, she developed chills and hypoxia (pulse oximetry at room air was 90%). The patient received diphenhydramine, 25 mg, meperidine hydrochloride, 25 mg, and intravenous dexamethasone, 20 mg. The symptoms ended within 20 minutes, and she received 250 mg/m2 of both 5-fluorouracil and leucovorin without incident.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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