Jiun-I Lai1, Wei-Shu Wang2,3. 1. Department of Medicine, National Yang-Ming University Hospital, Yilan, Taiwan. 2. Department of Medicine, National Yang-Ming University Hospital, Yilan, Taiwan. 11313@ymuh.ym.edu.tw. 3. National Yang-Ming University School of Medicine, National Yang-Ming University Hospital, No. 152, Xin-Min Road, Yilan, 26042, Taiwan. 11313@ymuh.ym.edu.tw.
Abstract
OBJECTIVE: To report a case of immune mediated hemolysis occurring after oxaliplatin infusion in a patient with rectal cancer. CASE SUMMARY: We report a 69 year old male patient who presented with acute onset anemia after infusion of oxaliplatin as chemotherapy. A positive direct Coombs test and good response to steroids treatment underlined the diagnosis of immune related hemolytic anemia. The patient was switched to irinotecan-based chemotherapy regimen for further treatment. DISCUSSION: To our knowledge, there has been less than 10 cases of hemolysis occurring after oxaliplatin treatment in the medical literature. In all cases, immune mediated hemolysis has been proven with a positive coombs test. As oxaliplatin based chemotherapy regimen has become a standardized first line treatment for metastatic colorectal adenocarcinoma, this phenomenon warrants a higher level of physician awareness. CONCLUSIONS: Oxaliplatin related hemolytic anemia is a rare reported phenomenon. Patient under oxaliplatin treatment presenting with sudden hemoglobin decrease should prompt further investigation of hemolysis.
OBJECTIVE: To report a case of immune mediated hemolysis occurring after oxaliplatin infusion in a patient with rectal cancer. CASE SUMMARY: We report a 69 year old male patient who presented with acute onset anemia after infusion of oxaliplatin as chemotherapy. A positive direct Coombs test and good response to steroids treatment underlined the diagnosis of immune related hemolytic anemia. The patient was switched to irinotecan-based chemotherapy regimen for further treatment. DISCUSSION: To our knowledge, there has been less than 10 cases of hemolysis occurring after oxaliplatin treatment in the medical literature. In all cases, immune mediated hemolysis has been proven with a positive coombs test. As oxaliplatin based chemotherapy regimen has become a standardized first line treatment for metastatic colorectal adenocarcinoma, this phenomenon warrants a higher level of physician awareness. CONCLUSIONS:Oxaliplatin related hemolytic anemia is a rare reported phenomenon. Patient under oxaliplatin treatment presenting with sudden hemoglobin decrease should prompt further investigation of hemolysis.
Authors: Vivien M Y Chen; Karen M Thrift; Marie-Christine Morel-Kopp; David Jackson; Christopher M Ward; Robert L Flower Journal: Transfusion Date: 2004-06 Impact factor: 3.157
Authors: A K Koutras; T Makatsoris; F Paliogianni; G Kopsida; A Onyenadum; C A Gogos; A Mouzaki; H P Kalofonos Journal: Oncology Date: 2004 Impact factor: 2.935