Abstract

Oxaliplatin is a third generation platinum derivative, commonly used in the practice of oncology. The usual side effects include nausea, vomiting, diarrhea, neuropathy and myelosuppression. Oxaliplatin-induced immune thrombocytopenia and immune hemolytic anemia have rarely been reported. Herein, a case of oxaliplatin-induced autoimmune hemolytic anemia(AIHA) and its management have been discussed. The patient with metastatic colorectal carcinoma was admitted to the emergency room with the symptom of reddish coloration of her urine after receiving an oxaliplatin-based regimen. On her admission she had profound anemia with reticulocytosis and a serum biochemistry concordant with hemolysis. The positivity of direct and indirect Coombs tests pointed to the diagnosis of AIHA. Hemolysis improved after discontinuation of oxaliplatin and treatment with corticosteroids and plasmapheresis. Although oxaliplatin has a relatively favorable side effect profile, the possibility of less frequent, but potentially serious immune-related side effects should never be overlooked.