Chonnam Med J.  2010 Aug;46(2):125-128. 10.4068/cmj.2010.46.2.125.

A Case of Autoimmune Hemolytic Anemia Caused by Repeated Administration of Oxaliplatin

• Kim DE
• Cho DH
• Rew SY
• Hwang JE
• Bae WK
• Shim HJ
• Chung IJ

• KMID: 1730011
• DOI: http://doi.org/10.4068/cmj.2010.46.2.125

Abstract

Oxaliplatin is widely used as a chemotherapeutic agent for treating unresectable or metastatic gastrointestinal tract cancer, such as gastric cancer and colorectal cancer. The toxic effects commonly associated with oxaliplatin include neuropathy, myelosuppression, hypersensitivity reactions, and chemotherapy-induced hepatotoxicity. However, oxaliplatin-induced hemolytic anemia has rarely been reported in the medical literature. Herein, we describe a case of oxaliplatin-induced autoimmune hemolytic anemia in a patient with metastatic gastric cancer who received biweekly oxaliplatin-based chemotherapy that included fluorouracil and folinic acid. He presented with acute-onset anemia and acute renal failure shortly after the 25th course of oxaliplatin-based chemotherapy. A positive direct and indirect Coombs test and a good response to steroid therapy suggested the diagnosis of autoimmune hemolytic anemia. Afterwards, the patient was switched to an oral 5-fluorouracil agent, TS-1, for further treatment.

Keyword

Oxaliplatin; Anemia, Hemolytic; Stomach neoplasms

MeSH Terms

Acute Kidney Injury
Anemia
Anemia, Hemolytic
Anemia, Hemolytic, Autoimmune
Colorectal Neoplasms
Coombs Test
Fluorouracil
Gastrointestinal Neoplasms
Humans
Hypersensitivity
Leucovorin
Organoplatinum Compounds
Silicates
Stomach Neoplasms
Titanium
Fluorouracil
Leucovorin
Organoplatinum Compounds
Silicates
Titanium

Figure

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  Fig. 1 (A) CT demonstrated the advanced gastric cancer with multiple liver metastasis at initial diagnosis. (B) After twenty fifth course of FOLFOX chemotherapy, multiple liver metastasis was markedly improved.

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  Fig. 2 Peripheral blood smear revealed many spherocytes, mild anisocytosis, and normocytic normochromic anemia.

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