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奥沙利铂诱导免疫性全血细胞减少1例报告并文献复习

王雨蒙,彭    智,陆    明,周    军,张小田,李    健,沈    琳   

  1. 北京大学肿瘤医院暨北京市肿瘤防治研究所消化肿瘤内科  恶性肿瘤发病机制及转化研究教育部重点实验室,北京 100142
  • 出版日期:2017-04-01 发布日期:2017-03-31

  • Online:2017-04-01 Published:2017-03-31

摘要:

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。

关键词: 奥沙利铂, 免疫性血细胞减少, 过敏反应, 胃癌根治术

Abstract:

Oxaliplatin-induced immune pancytopenia: A report of 1 case and literature review        WANG Yu-meng,PENG Zhi,LU Ming, et al. Department of Gastrointestinal Oncology,Peking University Cancer Hospital & Institute,Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education),Beijing 100142,China
Corresponding author:SHEN Lin,E-mail: linshenpku@163.com
Abstract    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.

Key words: oxaliplatin, immune cytopenia, allergic reactions, redical gastrectomy