• PDF / 140,372 Bytes
• 1 Pages / 595.245 x 841.846 pts (A4) Page_size
• 86 Downloads / 196 Views

DOWNLOAD

REPORT

---

1

S

Tumour lysis syndrome and fatal pancytopenia in an elderly patient: case report An 87-year-old woman with Merkel cell carcinoma developed tumour lysis syndrome (TLS) while receiving carboplatin and etoposide; she subsequently developed fatal pancytopenia. The woman received three cycles of weekly chemotherapy with carboplatin AUC5 on day 1 and etoposide 75 mg/m2 on days 1-3 [routes not stated]. After three cycles, she received radiotherapy and achieved complete clinical remission. She was diagnosed with major recurrence 3 months later, and carboplatin and etoposide were restarted at the same dosages. On day 3, she had a creatinine level of 2.04 mg/dL and an LDH level of 2144 IU/L. The third dose of etoposide was withheld. On day 4, laboratory investigations included the following: creatinine 2.1 mg/dL, uric acid 15.4 mg/dL, phosphate 7.2 mg/dL and potassium 4.7 mg/dL. Her urine output decreased to 400mL/24h. Her condition improved over the following 3 days, but a full blood count disclosed severe pancytopenia. She developed fever and worsening dyspnoea. Despite treatment with filgrastim, antibiotics, packed RBCs and platelet transfusions, the woman’s condition deteriorated and she died on hospital day 22. Author comment: "In our patient, [tumour lysis syndrome] caused [acute kidney injury] and delayed clearance of carboplatin. As a result, carboplatin AUC was higher than targeted, leading to extended exposure to this drug and severe haematological toxicity." Grenader T, et al. Tumor lysis syndrome in a patient with merkel cell carcinoma and provoked pathologic sequence of acute kidney injury, reduced clearance of carboplatin and fatal pancytopenia. Onkologie 34: 626-629, No. 11, Nov 2011. 803066698 Available from: URL: http://dx.doi.org/10.1159/000334196 - Israel

0114-9954/10/1387-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved

Reactions 4 Feb 2012 No. 1387