Chinese Medical Sciences Journal ›› 2020, Vol. 35 ›› Issue (4): 377-382.doi: 10.24920/003799

• 病例报告 • 上一篇    下一篇

曲妥珠单抗致重度血小板减少症一例及文献回顾

曾晓淇1,姜珊珊2,彭远洋1,刘民锋1,叶长生1,董建宇1,*()   

  1. 1南方医科大学南方医院乳腺科,广州 510515,中国
    2陕西省人民医院血液病研究室,西安 710068,中国
  • 接受日期:2020-07-17 出版日期:2020-12-31 发布日期:2021-01-08
  • 通讯作者: 董建宇 E-mail:djypumc@163.com

Trastuzumab-Induced Severe Thrombocytopenia:A Case Report and Literature Review

Xiaoqi Zeng1,Shanshan Jiang2,Yuanyang Peng1,Minfeng Liu1,Changsheng Ye1,Jianyu Dong1,*()   

  1. 1Breast Center, Department of General Surgery, Nanfang Hospital,Southern Medical University, Guangzhou 510515, China
    2Institute of Hematological Research, Shaanxi Provincial People’s Hospital, Xi’an 710000, China
  • Accepted:2020-07-17 Published:2020-12-31 Online:2021-01-08
  • Contact: Jianyu Dong E-mail:djypumc@163.com

摘要:

我们报告一例29岁浸润性导管癌pT2N0M0女性患者,ER和PR均弱阳性,Her-2(3+),患者在我中心接受化疗和曲妥珠单抗治疗。于第二周期注射曲妥珠单抗6小时后出现异常子宫出血,血小板计数急剧降至3×109/L,临床确诊为曲妥珠单抗所致严重血小板减少症。给予输注血小板、糖皮质激素、缩宫素及升血小板药物治疗,11天后患者的血小板完全恢复正常。由于严重血小板减少症由曲妥珠单抗所致,患者终止并未再继续尝试曲妥珠单抗治疗。随着曲妥珠单抗在临床逐渐广泛应用,临床医生可能会越来越多地遇到由曲妥珠单抗引起的致命性严重血小板减少症。我们希望通过此病例报告和文献回顾,引起临床医生对此种情况的警惕和重视,助益提升治疗效果。

关键词: 乳腺癌, 曲妥珠单抗, 血小板, 血小板减少症

Abstract:

We present a 29-year-old woman with pT2N0M0 breast cancer, histological diagnosis of invasive ductal carcinoma, ER and PR low positive, and HER-2 (3+). The patient developed trastuzumab-induced thrombocytopenia in 6 hours after an intravenous infusion of trastuzumab at the second cycle of trastuzumab treatment with the symptom of abnormal uterine bleeding. Laboratory exam revealed a sharp drop of platelet count down to 3×109/L. With the treatment of single-donor platelet transfusions, glucocorticoids, oxytocin and thrombopoietic drugs, the platelet count recovered completely in 11 days. This case was confirmed to be severe thrombocytopenia induced by trastuzumab, and retreatment with trastuzumab was not attempted. With increasing clinical utilization of trastuzumab, clinicians are likely to encounter more life-threatening trastuzumab induced severe thrombocytopenia. By this case report and literature review, we hope to increase the awareness, attach the attentions to this condition, and help with the effective treatment.

Key words: breast cancer, trastuzumab, platelet, thrombocytopenia

基金资助: 南方医科大学南方医院院长基金(2016L007)

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