Calcium folinate rescue therapy for severe myelosuppression induced by pemetrexed
10.3760/cma.j.issn.1008﹣5734.2019.04.017
- VernacularTitle:亚叶酸钙解救培美曲塞所致重度骨髓抑制
- Author:
Xin NIE
1
;
Ping ZHANG
1
;
Gang CHENG
1
;
Hong SHI
1
;
Lin LI
1
Author Information
1. 北京医院肿瘤内科/国家老年医学中心100730
- Publication Type:Journal Article
- Keywords:
Pemetrexed;
Pancytopenia;
Leucovorin;
Salvage therapy
- From:
Adverse Drug Reactions Journal
2019;21(4):305-306
- CountryChina
- Language:Chinese
-
Abstract:
A 70﹣year﹣old female patient received chemotherapy regimen of pemetrexed combined with cisplatin for metastatic non﹣small﹣cell lung cancer. After 2 cycles of chemotherapy,the tumor partly relieved,but the patient developed grade II leukopenia and serum creatinine elevation. Renal injury was considered to be caused by cisplatin. Therefore,cisplatin was discontinued in the third cycle and pemetrexed monotherapy was given. On day 10 of the chemotherapy,the patient developed fever and laboratory tests revealed pancytopenia,white blood cell count( WBC)1. 1 ×109/L,neutrophil count 0. 54 ×109/L, platelet count(PLT)63×109/L,hemoglobin(Hb)72 g/L,and red blood cell count(RBC)2. 23×1012/L. The patient received symptomatic and supportive treatments such as platelet and erythrocyte suspension infusion,and granulocyte colony stimulating factor subcutaneous injection,but her complete blood count continued to decline,with WBC 0. 2×109/L,neutrophil 0. 13×109/L,PLT 0×109/L,Hb 59 g/L,and RBC 1. 88×1012/L. Ⅳmyelosuppression induced by pemetrexed was diagnosed. Calcium folinate was given for rescue therapy(the first dose was 100 mg/m2 ,then 50 mg/m2 every 6 hours for 4 days). After 23 days of calcium folinate treatment,the laboratory tests showed WBC 6. 8×109/L,neutrophil 3. 84×109/L,PLT 169×109/L,Hb 95 g/L,and RBC 2. 99×1012/L.
