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Journal of Hematology & Oncology
Published in: Journal of Hematology & Oncology 1/2010

Open Access 01-12-2010 | Case report

Hypersensitivity reaction and acute immune-mediated thrombocytopenia from oxaliplatin: two case reports and a review of the literature

Authors: Marnelli A Bautista, W Tait Stevens, Chien-Shing Chen, Brian R Curtis, Richard H Aster, Chung-Tsen Hsueh

Published in: Journal of Hematology & Oncology | Issue 1/2010

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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.
Appendix
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Metadata
Title
Hypersensitivity reaction and acute immune-mediated thrombocytopenia from oxaliplatin: two case reports and a review of the literature
Authors
Marnelli A Bautista
W Tait Stevens
Chien-Shing Chen
Brian R Curtis
Richard H Aster
Chung-Tsen Hsueh
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Journal of Hematology & Oncology / Issue 1/2010
Electronic ISSN: 1756-8722
DOI
https://doi.org/10.1186/1756-8722-3-12

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