奥沙利铂诱导免疫性全血细胞减少1例报告并文献复习

Oxaliplatin-induced immune pancytopenia: A report of 1 case and literature review

目的探讨奥沙利铂诱导的免疫性血细胞减少的发生机制、临床特征、诊断及治疗。方法北京大学肿瘤医院收治1例胃癌根治术后病人,第6周期XELOX辅助化疗后1 d曾出现一过性寒战,于2016-09-22给予第7周期奥沙利铂输注后数小时内突发寒战、高热,血常规提示全血细胞减少,以白细胞和血小板为著,诊断为奥沙利铂诱导的免疫性全血细胞减少。结果经过给予糖皮质激素、输注红细胞及血浆等支持治疗后,病人症状迅速缓解,三系血细胞在数小时至数天内逐渐恢复。结论奥沙利铂诱导的免疫性血细胞减少系一种罕见的、潜在致命的药物不良反应,目前尚无标准治疗方案,准确及时的识别处理至关重要。

Objective To investigate the mechanism, clinical features, diagnosis and treatment of oxaliplatin-induced immune cytopenia. Methods Peking University Cancer Hospital had admitted a patient after radical gastrectomy, who suffered transient shiver in the 6th XELOX adjuvant chemotherapy, presented high fever with shiver several hours after infusion of oxaliplatin in the 7th on September 22th, 2016. Oxaliplatin-induced immune cytopenia was diagnosed for pancytopenia, especially leukopenia and thrombocytopenia. Results After the treatment of glucocorticoid, infusion of red blood cells and plasma, the symptoms of the patients were relieved rapidly, and the amount of the blood cells gradually recovered within a few hours to several days. Conclusion Oxaliplatin-induced immune cytopenia is a rare, potentially fatal adverse drug reaction, for which there is no standard treatment, and it requires early diagnosis and treatment.