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BMC Cancer
Published in: BMC Cancer 1/2006

Open Access 01-12-2006 | Case report

Plasmapheresis reverses all side-effects of a cisplatin overdose – a case report and treatment recommendation

Authors: Guenter Hofmann, Thomas Bauernhofer, Peter Krippl, Doris Lang-Loidolt, Sabine Horn, Walter Goessler, Walter Schippinger, Ferdinand Ploner, Herbert Stoeger, Hellmut Samonigg

Published in: BMC Cancer | Issue 1/2006

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Abstract

Background

Cisplatin is widely used as an antineoplastic agent since it is effective against a broad spectrum of different tumours. Nevertheless, it has several potential side effects affecting different organ systems and an overdose may lead to life-threatening complications and even death.

Case presentation

We report on a 46-year old woman with non-small cell lung cancer who accidentally received 225 mg/m2 of cisplatin, which was threefold the dose as scheduled, within a 3-day period. Two days later, the patient presented with hearing loss, severe nausea and vomiting, acute renal failure as well as elevated liver enzymes. In addition, she developed a severe myelodepression. After plasmapheresis on two consecutive days and vigorous supportive treatment, the toxicity-related symptoms improved and the patient recovered without any sequelae.

Conclusion

To date, no general accepted guidelines for the treatment of cisplatin overdoses are available. Along with the experience from other published cases, our report shows that plasmapheresis is capable of lowering cisplatin plasma and serum levels efficiently. Therefore, plasma exchange performed as soon as possible can ameliorate all side effects of a cisplatin overdose and be a potential tool for clinicians for treatment. However, additional intensive supportive treatment-modalities are necessary to control all occurring side effects.
Appendix
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Literature
1.
Markman M: Toxicities of the platinum antineoplastic agents. Expert Opin Drug Saf. 2003, 2 (6): 597-607. 10.1517/14740338.2.6.597.CrossRefPubMed
2.
Hartmann JT, Lipp HP: Toxicity of platinum compounds. Expert Opin Pharmacother. 2003, 4 (6): 889-901. 10.1517/14656566.4.6.889.CrossRefPubMed
3.
Pike IM, Arbus MH: Cisplatin overdosage. J Clin Oncol. 1992, 10 (9): 1503-1504.PubMed
4.
Blakley BW, Cohen JI, Doolittle ND, Muldoon LL, Campbell KC, Dickey DT, Neuwelt EA: Strategies for prevention of toxicity caused by platinum-based chemotherapy: review and summary of the annual meeting of the Blood-Brain Barrier Disruption Program, Gleneden Beach, Oregon, March 10, 2001. Laryngoscope. 2002, 112 (11): 1997-2001. 10.1097/00005537-200211000-00016.CrossRefPubMed
5.
Chen CS, Seidel K, Armitage JO, Fay JW, Appelbaum FR, Horowitz MM, Shpall EJ, Weiden PL, Antman KS, Champlin RE, Kersey JH, Sullivan KM: Safeguarding the administration of high-dose chemotherapy: a national practice survey by the American Society for Blood and Marrow Transplantation. Biol Blood Marrow Transplant. 1997, 3 (6): 331-340.PubMed
6.
Lagrange JL, Cassuto-Viguier E, Barbe V, Fischel JL, Mondain JR, Etienne MC, Ferrero JM, Creisson-Ducray A, Formento P, Milano G: Cytotoxic effects of long-term circulating ultrafiltrable platinum species and limited efficacy of haemodialysis in clearing them. Eur J Cancer. 1994, 30A (14): 2057-2060. 10.1016/0959-8049(94)00332-Y.CrossRefPubMed
7.
Brivet F, Pavlovitch JM, Gouyette A, Cerrina ML, Tchernia G, Dormont J: Inefficiency of early prophylactic hemodialysis in cis-platinum overdose. Cancer Chemother Pharmacol. 1986, 18 (2): 183-184. 10.1007/BF00262294.CrossRefPubMed
8.
Chu G, Mantin R, Shen YM, Baskett G, Sussman H: Massive cisplatin overdose by accidental substitution for carboplatin. Toxicity and management. Cancer. 1993, 72 (12): 3707-3714.CrossRefPubMed
9.
Charlier C, Kintz P, Dubois N, Plomteux G: Fatal overdosage with cisplatin. J Anal Toxicol. 2004, 28 (2): 138-140.CrossRefPubMed
10.
Sheikh-Hamad D, Timmins K, Jalali Z: Cisplatin-induced renal toxicity: possible reversal by N-acetylcysteine treatment. J Am Soc Nephrol. 1997, 8 (10): 1640-1644.PubMed
11.
Wu YJ, Muldoon LL, Neuwelt EA: The chemoprotective agent N-acetylcysteine blocks cisplatin-induced apoptosis through caspase signaling pathway. J Pharmacol Exp Ther. 2005, 312 (2): 424-431. 10.1124/jpet.104.075119.CrossRefPubMed
12.
Erdlenbruch B, Pekrun A, Schiffmann H, Witt O, Lakomek M: Topical topic: accidental cisplatin overdose in a child: reversal of acute renal failure with sodium thiosulfate. Med Pediatr Oncol. 2002, 38 (5): 349-352. 10.1002/mpo.1343.CrossRefPubMed
13.
Ekborn A, Hansson J, Ehrsson H, Eksborg S, Wallin I, Wagenius G, Laurell G: High-dose Cisplatin with amifostine: ototoxicity and pharmacokinetics. Laryngoscope. 2004, 114 (9): 1660-1667. 10.1097/00005537-200409000-00030.CrossRefPubMed
14.
Sastry J, Kellie SJ: Severe neurotoxicity, ototoxicity and nephrotoxicity following high-dose Cisplatin and amifostine. Pediatr Hematol Oncol. 2005, 22 (5): 441-445. 10.1080/08880010590964381.CrossRefPubMed
15.
ASHP guidelines on preventing medication errors with antineoplastic agents. Am J Health Syst Pharm. 2002, 59 (17): 1648-1668.
16.
Criteria for facilities and personnel for the administration of parenteral systemic antineoplastic therapy. Adopted on March 3, 2004 by the American Society of Clinical Oncology. J Clin Oncol. 2004, 22 (22): 4613-4615. 10.1200/JCO.2004.05.077.
17.
Womer RB, Tracy E, Soo-Hoo W, Bickert B, DiTaranto S, Barnsteiner JH: Multidisciplinary systems approach to chemotherapy safety: rebuilding processes and holding the gains. J Clin Oncol. 2002, 20 (24): 4705-4712. 10.1200/JCO.2002.04.108.CrossRefPubMed
18.
Pourrat X, Antier D, Crenn I, Calais G, Jonville-Bera AP, Rouleau A: A prescription and administration error of cisplatin: a case report. Pharm World Sci. 2004, 26 (2): 64-65. 10.1023/B:PHAR.0000018602.02535.70.CrossRefPubMed
19.
Choi JH, Oh JC, Kim KH, Chong SY, Kang MS, Oh do Y: Successful treatment of cisplatin overdose with plasma exchange. Yonsei Med J. 2002, 43 (1): 128-132.CrossRefPubMed
20.
21.
Linenberger ML, Price TH: Use of cellular and plasma apheresis in the critically ill patient: part 1: technical and physiological considerations. J Intensive Care Med. 2005, 20 (1): 18-27. 10.1177/0885066604271394.CrossRefPubMed
22.
Linenberger ML, Price TH: Use of cellular and plasma apheresis in the critically ill patient: Part II: Clinical indications and applications. J Intensive Care Med. 2005, 20 (2): 88-103. 10.1177/0885066604273479.CrossRefPubMed
23.
Stegmayr B, Wikdahl AM: Access in therapeutic apheresis. Ther Apher Dial. 2003, 7 (2): 209-214. 10.1046/j.1526-0968.2003.00035.x.CrossRefPubMed
24.
Mallat SG, Ismail N: Plasmapheresis and related techniques: what should we know. J Med Liban. 2002, 50 (1-2): 45-49.PubMed
25.
Rule AD, Larson TS, Bergstralh EJ, Slezak JM, Jacobsen SJ, Cosio FG: Using serum creatinine to estimate glomerular filtration rate: accuracy in good health and in chronic kidney disease. Ann Intern Med. 2004, 141 (12): 929-937.CrossRefPubMed
Metadata
Title
Plasmapheresis reverses all side-effects of a cisplatin overdose – a case report and treatment recommendation
Authors
Guenter Hofmann
Thomas Bauernhofer
Peter Krippl
Doris Lang-Loidolt
Sabine Horn
Walter Goessler
Walter Schippinger
Ferdinand Ploner
Herbert Stoeger
Hellmut Samonigg
Publication date
01-12-2006
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2006
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-6-1

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