Reactions 1704, p103 - 2 Jun 2018 Thrombotic thrombocytopenic purpura: case report A 63-year-old man developed fatal thrombotic thrombocytopenic purpura (TTP) during treatment with cisplatin and gimeracil/oteracil/tegafur [TS-1] for basaloid carcinoma of the oesophagus [routes and time to reaction onset not stated]. The man was diagnosed with basaloid carcinoma of the oesophagus and received one course of gimeracil/oteracil/ tegafur 100 mg/body, days 1-28. After the definitive histologic diagnosis, a total of four courses of gimeracil/oteracil/tegafur 100 mg/body, days 1-14 plus cisplatin 40 mg/body, day 1 were initiated with a satisfactory response. In February 2015, he underwent oesophageal resection with right thoracotomy and laparotomy along with re-constructive surgery for the thoracic gastric duct. Thereafter, from March 2015, post-operative adjuvant chemotherapy was started with gimeracil/oteracil/ tegafur 80 mg/body, day 1-14 plus cisplatin 40 mg/body, day 1. After the completion of eight courses, a decrease in the platelet count was observed. Therefore, the chemotherapy was stopped. Blood tests showed platelet count of 0.6 x 10 /µL, WBC count of 5400 /µL and Hb level of 10.4 g/dL. Based on the clinical findings, he was diagnosed with TTP, which was considered to be related to cisplatin and gimeracil/ oteracil/tegafur. The man was treated with plasma exchange and unspecified steroid pulse therapies. He showed no response towards the therapy and eventually, he died of the TTP and progression of the underlying disease. Author comment: We experienced a rare case of surgery performed on a basaloid carcinoma patient who had responded to pre-operative chemotherapy, in which secondary thrombotic thrombocytopenic purpura (TTP) developed during post-operative chemotherapy. There is one reported case of TTP related to [gimeracil/oteracil/tegafur] and [cisplatin]. Watanabe A, et al. A Patient with Basaloid Carcinoma of the Esophagus Removed Surgically after Pre-Operative Chemotherapy Who Developed TTP during Post- Operative Chemotherapy. Gan to Kagaku Ryoho 44: 1110-1113, No. 12, Nov 2017 [Japanese; summarised from a translation] - Japan 803323923 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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