Cisplatin-Induced Hemolysis

New England Journal of Medicine (Impact Factor: 55.87). 03/1980; 302(6):334-5. DOI: 10.1056/NEJM198002073020607
Source: PubMed


Cisplatin (cis-diamminedichloroplatinum) has been tested extensively against various solid tumors and has become commercially available. Recently, we saw two patients who had positive responses to the direct antiglobulin test while they were receiving cisplatin; one had overt hemolysis when challenged with the drug.

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    • "The haemolytic properties of Pt drugs during chemotherapy are also responsible for higher risks of blood diseases like anaemia [28]. Comparing the results of this study with previous reports on the haemocompatibility of cisplatin confirmed the haemolytic activity of Pt-based drugs as one of the main side effects causing haemolytic anaemia and also bone marrow diseases and haemolysis [2,29]. The present results demonstrated that both cisplatin and NP-Pt induced haemolysis compared to the control group. "
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    ABSTRACT: Side effects and resistance of cancer cells to cisplatin are major drawbacks to its application, and recently, the possibility of replacing cisplatin with nanocompounds has been considered. Most chemotherapeutic agents are administered intravenously, and comparisons between the interactions of platinum nanoparticles (NP-Pt) and cisplatin with blood compartments are important for future applications. This study investigated structural damage, cell membrane deformation and haemolysis of chicken embryo red blood cells (RBC) after treatment with cisplatin and NP-Pt. Cisplatin (4 μg/ml) and NP-Pt (2,6 μg/ml), when incubated with chicken embryo RBC, were detrimental to cell structure and induced haemolysis. The level of haemolytic injury was increased after cisplatin and NP-Pt treatments compared to the control group. Treatment with cisplatin caused structural damage to cell membranes and the appearance of keratocytes, while NP-Pt caused cell membrane deformations (discoid shape of cells was lost) and the formation of knizocytes and echinocytes. This work demonstrated that NP-Pt have potential applications in anticancer therapy, but potential toxic side effects must be explored in future preclinical research.
    Nanoscale Research Letters 05/2014; 9(1):257. DOI:10.1186/1556-276X-9-257 · 2.78 Impact Factor
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    ABSTRACT: Normochromic or normocytic anaemia is a common side effect of treatment with cisplatin. Two patients treated with cisplatin 100 mg/m2 in combination with vinblastine, bleomycin, and actinomycin D developed haemolytic anaemia. Neither patient had evidence of haemolysis before treatment, and in both cases severe haemolytic anaemia developed after several courses of cisplatin and when the cancer had regressed almost completely. The importance of haemolysis in the development of anaemia after cisplatin treatment has not been investigated fully and further studies are needed.
    British medical journal (Clinical research ed.) 07/1981; 282(6281):2003-4. DOI:10.1136/bmj.282.6281.2003
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    ABSTRACT: Bleomycin (Blenoxane) and cisplatin (Platinol) are two anticancer drugs with activity for head and neck tumors. Introduced into clinical use in the past ten years, bleomycin is used primarily in the chemotherapy of squamous cell carcinomas, lymphomas, and testicular carcinoma, while cisplatin is effective against testicular and ovarian carcinoma, head and neck cancer, bladder cancer, and neuroblastoma. Bleomycin is rapidly excreted renally (T 1/2 beta = 2-4 hr) although enzymatic inactivation also occurs in many tissues. Cisplatin is nonenzymatically converted to highly protein-bound metabolites, which then undergo renal elimination, but total body clearance occurs much more slowly than with bleomycin (T 1/2 beta = 40-50 hr). Both agents have acute and chronic toxicities; the acute toxicities are generally reversible but cause a great deal of patient discomfort, while the chronic toxicities are often irreversible and dose-limiting. For bleomycin, the acute toxicities are mucocutaneous and pyretic, while severe nausea and vomiting represent the major acute toxicities of cisplatin therapy. Cumulative dose-related pulmonary toxicity is the most serious chronic toxicity of bleomycin. The clinical, radiographic, and pathologic presentations are nonspecific, although identification of high-risk patients may be possible with serial pulmonary function tests. Cumulative nephrotoxicity occurs with cisplatin use and its incidence and severity can be reduced by maintaining adequate hydration and diuresis during and following administration of the drug.
    Head & Neck Surgery 11/1981; 4(2):98-110. DOI:10.1002/hed.2890040204
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