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Published in: BMC Clinical Pharmacology 1/2006

Open Access 01-12-2006 | Case report

Hemolytic uremic syndrome following the infusion of oxaliplatin: case report

Authors: Issa Dahabreh, George Tsoutsos, Dimitrios Tseligas, Dimitrios Janinis

Published in: BMC Clinical Pharmacology | Issue 1/2006

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Abstract

Background

Oxaliplatin is a platinum derivative, which is used in the treatment of colorectal cancer. A small number of oxaliplatin-related hemolytic and/or thrombocytopenic reactions have been reported. We present a case of hemolytic-uremic syndrome that developed during the 4th cycle of combination chemotherapy with oxaliplatin, 5-fluorouracil and leucovorin.

Case presentation

A 52-year-old-male was administered chemotherapy with oxaliplatin, 5-fluorouracil and leucovorin for a Duke's stage C colorectal carcinoma. Three cycles of chemotherapy had been administered without complications when, at the beginning of the fourth cycle, the patient developed clinical and laboratory abnormalities consistent with the development of the hemolytic-uremic syndrome. Treatment was discontinued; the patient was managed with monitored IV hydration and loop diuretics, high dose corticosteroids and fresh frozen plasma infusions and recovered completely.

Conclusion

The hemolytic-uremic syndrome may be a rare complication of oxaliplatin-based chemotherapy. Clinicians need to maintain a high index of suspicion to diagnose and treat this life-threatening adverse event.
Literature
1.
go back to reference Meyerhardt J, Mayer R: Systemic therapy for colorectal cancer. N Engl J Med. 2005, 352: 476-487. 10.1056/NEJMra040958.CrossRefPubMed Meyerhardt J, Mayer R: Systemic therapy for colorectal cancer. N Engl J Med. 2005, 352: 476-487. 10.1056/NEJMra040958.CrossRefPubMed
2.
go back to reference Cassidy J, Misset JL: Oxaliplatin-related side effects: characteristics and management. Semin Oncol. 2002, 29: 11-20. 10.1053/sonc.2002.35524.CrossRefPubMed Cassidy J, Misset JL: Oxaliplatin-related side effects: characteristics and management. Semin Oncol. 2002, 29: 11-20. 10.1053/sonc.2002.35524.CrossRefPubMed
3.
go back to reference Chen V, Thrift K, Morel-Kopp MC, Jackson D, Ward CM, Flower R: An immediate hemolytic reaction induced by repeated administration of oxaliplatin. Transfusion. 2004, 44: 838-843. 10.1111/j.1537-2995.2004.03111.x.CrossRefPubMed Chen V, Thrift K, Morel-Kopp MC, Jackson D, Ward CM, Flower R: An immediate hemolytic reaction induced by repeated administration of oxaliplatin. Transfusion. 2004, 44: 838-843. 10.1111/j.1537-2995.2004.03111.x.CrossRefPubMed
4.
go back to reference Dold FG, Mitchell EP: Sudden-onset thrombocytopenia with oxaliplatin. Ann Intern Med. 2003, 139: e156-e157.CrossRefPubMed Dold FG, Mitchell EP: Sudden-onset thrombocytopenia with oxaliplatin. Ann Intern Med. 2003, 139: e156-e157.CrossRefPubMed
5.
go back to reference Desrame J, Broustet H, Darodes de Tailly P, Girard D, Saissy JM: Oxaliplatin-induced haemolytic anaemia. Lancet. 1999, 354: 1179-80. 10.1016/S0140-6736(99)03827-1.CrossRefPubMed Desrame J, Broustet H, Darodes de Tailly P, Girard D, Saissy JM: Oxaliplatin-induced haemolytic anaemia. Lancet. 1999, 354: 1179-80. 10.1016/S0140-6736(99)03827-1.CrossRefPubMed
7.
go back to reference Garufi C, Vaglio S, Brienza S, Conti L, D' Attino RM, Girelli G, Terzoli E: Immunohemolytic anemia following oxaliplatin administration. Ann Oncol. 2000, 11: 497-497. 10.1023/A:1008336108007.CrossRefPubMed Garufi C, Vaglio S, Brienza S, Conti L, D' Attino RM, Girelli G, Terzoli E: Immunohemolytic anemia following oxaliplatin administration. Ann Oncol. 2000, 11: 497-497. 10.1023/A:1008336108007.CrossRefPubMed
8.
go back to reference Hofheinz RD, Nguyen XD, Buchheidt D, Kerowgan M, Hehlmann R, Hochhaus A: Two potential mechanisms of oxaliplatin-induced haemolytic anaemia in a single patient. Cancer Chemother Pharmacol. 2004, 53: 276-277. 10.1007/s00280-003-0731-8.CrossRefPubMed Hofheinz RD, Nguyen XD, Buchheidt D, Kerowgan M, Hehlmann R, Hochhaus A: Two potential mechanisms of oxaliplatin-induced haemolytic anaemia in a single patient. Cancer Chemother Pharmacol. 2004, 53: 276-277. 10.1007/s00280-003-0731-8.CrossRefPubMed
9.
go back to reference Sorbye H, Bruserud O, Dahl O: Oxaliplatin-induced haematological emergency with an immediate severe thrombocytopenia and haemolysis. Acta Oncol. 2001, 40: 882-883. 10.1080/02841860152703553.CrossRefPubMed Sorbye H, Bruserud O, Dahl O: Oxaliplatin-induced haematological emergency with an immediate severe thrombocytopenia and haemolysis. Acta Oncol. 2001, 40: 882-883. 10.1080/02841860152703553.CrossRefPubMed
10.
go back to reference Taleghani BM, Fontana S, Meyer O, Ahrens N, Novac U, Borner M, Salama A: Oxaliplatin-induced immune pancytopenia. Transfusion. 2005, 45: 704-708. 10.1111/j.1537-2995.2005.04373.x.CrossRefPubMed Taleghani BM, Fontana S, Meyer O, Ahrens N, Novac U, Borner M, Salama A: Oxaliplatin-induced immune pancytopenia. Transfusion. 2005, 45: 704-708. 10.1111/j.1537-2995.2005.04373.x.CrossRefPubMed
11.
go back to reference Koutras AK, Makatsoris T, Paliogianni F, Kopsida G, Onyenadum A, Gogos CA, Mouzaki A, Kalofonos HP: Oxaliplatin-induced acute-onset thrombocytopenia, haemorrhage and hemolysis. Oncology. 2004, 67: 179-182. 10.1159/000081006.CrossRefPubMed Koutras AK, Makatsoris T, Paliogianni F, Kopsida G, Onyenadum A, Gogos CA, Mouzaki A, Kalofonos HP: Oxaliplatin-induced acute-onset thrombocytopenia, haemorrhage and hemolysis. Oncology. 2004, 67: 179-182. 10.1159/000081006.CrossRefPubMed
12.
13.
go back to reference Tsai HM: Advances in the pathogenesis, diagnosis and treatment of thrombotic thrombocytopenic purpura. J Am Soc Nephrol. 2003, 14: 1072-1081. 10.1097/01.ASN.0000060805.04118.4C.CrossRefPubMed Tsai HM: Advances in the pathogenesis, diagnosis and treatment of thrombotic thrombocytopenic purpura. J Am Soc Nephrol. 2003, 14: 1072-1081. 10.1097/01.ASN.0000060805.04118.4C.CrossRefPubMed
14.
go back to reference Mayer S, Aledort L: Thrombotic microangiopathy: differential diagnosis, pathophysiology and therapeutic strategies. Mt Sinai J Med. 2005, 72: 166-175.PubMed Mayer S, Aledort L: Thrombotic microangiopathy: differential diagnosis, pathophysiology and therapeutic strategies. Mt Sinai J Med. 2005, 72: 166-175.PubMed
15.
go back to reference George J: How I treat patients with thrombotic thrombocytopenic purpura-hemolytic uremic syndrome. Blood. 2000, 96: 1223-1229.PubMed George J: How I treat patients with thrombotic thrombocytopenic purpura-hemolytic uremic syndrome. Blood. 2000, 96: 1223-1229.PubMed
16.
go back to reference Tostivit I, Mougenot B, Flahault A, Vigneau C, Costa MA, Haymann JP, Sraer JD, Rondeau E: Adult haemolytic uraemic syndrome: causes and prognostic factors in the last decade. Nephrol Dial Transplant. 2002, 17: 1228-1234. 10.1093/ndt/17.7.1228.CrossRef Tostivit I, Mougenot B, Flahault A, Vigneau C, Costa MA, Haymann JP, Sraer JD, Rondeau E: Adult haemolytic uraemic syndrome: causes and prognostic factors in the last decade. Nephrol Dial Transplant. 2002, 17: 1228-1234. 10.1093/ndt/17.7.1228.CrossRef
17.
go back to reference George JN: Clinical practice. Thrombotic thrombocytopenic porpura. N Engl J Med. 2006, 354: 1927-1935. 10.1056/NEJMcp053024.CrossRefPubMed George JN: Clinical practice. Thrombotic thrombocytopenic porpura. N Engl J Med. 2006, 354: 1927-1935. 10.1056/NEJMcp053024.CrossRefPubMed
18.
go back to reference Medina PJ, Sipols JM, George JN: Drug-associated thrombotic thrombocytopenic purpura-hemolytic uremic syndrome. Curr Opin Hematol. 2001, 8: 286-293. 10.1097/00062752-200109000-00004.CrossRefPubMed Medina PJ, Sipols JM, George JN: Drug-associated thrombotic thrombocytopenic purpura-hemolytic uremic syndrome. Curr Opin Hematol. 2001, 8: 286-293. 10.1097/00062752-200109000-00004.CrossRefPubMed
19.
go back to reference Cantrell JE, Phillips TM, Schein PS: Carcinoma-associated hemolytic-uremic syndrome: a complication of mitomycin C chemotherapy. J Clin Oncol. 1985, 3: 723-734.PubMed Cantrell JE, Phillips TM, Schein PS: Carcinoma-associated hemolytic-uremic syndrome: a complication of mitomycin C chemotherapy. J Clin Oncol. 1985, 3: 723-734.PubMed
20.
go back to reference Lesesne JB, Rothschild N, Erickson B, Korec S, Sisk R, Keller J, Arbus M, Woolley PV, Chiazze L, Schein PS, Neefe JR: Cancer-associated hemolytic-uremic syndrome: analysis of 85 cases from a national registry. J Clin Oncol. 1989, 7: 781-789.PubMed Lesesne JB, Rothschild N, Erickson B, Korec S, Sisk R, Keller J, Arbus M, Woolley PV, Chiazze L, Schein PS, Neefe JR: Cancer-associated hemolytic-uremic syndrome: analysis of 85 cases from a national registry. J Clin Oncol. 1989, 7: 781-789.PubMed
21.
go back to reference Ross P, Norman A, Cunningham D, Webb A, Iveson T, Padhani A, Prendiville J, Watson M, Massey A, Popescu R, Oates J: A prospective randomised trial of protracted venous infusion 5-fluorouracil with or without mitomycin C in advanced colorectal cancer. Ann Oncol. 1997, 8: 995-1001. 10.1023/A:1008263516099.CrossRefPubMed Ross P, Norman A, Cunningham D, Webb A, Iveson T, Padhani A, Prendiville J, Watson M, Massey A, Popescu R, Oates J: A prospective randomised trial of protracted venous infusion 5-fluorouracil with or without mitomycin C in advanced colorectal cancer. Ann Oncol. 1997, 8: 995-1001. 10.1023/A:1008263516099.CrossRefPubMed
22.
go back to reference Chau I, Cunningham D: Oxaliplatin for colorectal cancer in the United States: better late than never. J Clin Oncol. 2003, 21: 2049-2051. 10.1200/JCO.2003.03.074.CrossRefPubMed Chau I, Cunningham D: Oxaliplatin for colorectal cancer in the United States: better late than never. J Clin Oncol. 2003, 21: 2049-2051. 10.1200/JCO.2003.03.074.CrossRefPubMed
Metadata
Title
Hemolytic uremic syndrome following the infusion of oxaliplatin: case report
Authors
Issa Dahabreh
George Tsoutsos
Dimitrios Tseligas
Dimitrios Janinis
Publication date
01-12-2006
Publisher
BioMed Central
Published in
BMC Clinical Pharmacology / Issue 1/2006
Electronic ISSN: 1472-6904
DOI
https://doi.org/10.1186/1472-6904-6-5

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