Carboplatin-induced immune hemolytic anemia

T. M. Marani, M. B. Trich, K. S. Armstrong, P. M. Ness, J. Smith, Caterina P. Minniti, S. G. Sandler

Research output: Contribution to journalArticle

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Abstract

Background: A case of acute hemolysis following therapy with carboplatin, an anticancer chemotherapeutic agent, was investigated. Hemolytic anemia has been associated with cisplatin, a related drug, but not with carboplatin. Case Report: An 8-year-old boy was treated for an astrocytoma by monthly intravenous injections of carboplatin. Lower back pain was noted after 26 monthly injections, and overt intravascular hemolysis occurred after the 27th injection. The direct antiglobulin test was 4+ with anti-IgG and 1+ with anti-C3d. Results: Blood samples obtained on Days 28 and 56 after the last injection were tested for carboplatin-dependent antibody. The direct antiglobulin test was 1+ with anti-IgG; the eluate was 1+ with and without carboplatin. The serum indirect antiglobulin test was negative in the absence of carboplatin, 3+ to 4+ in the presence of carboplatin, and 1+ with carboplatin-coated cells. Day 56 serum antibody titer was 64 (agglutination at 37°C), 512 (indirect antiglobulin test) in the presence of carboplatin, and 8 (indirect antiglobulin test) with carboplatin-coated cells. Conclusion: The findings indicate a carboplatin-induced antibody reacting in vitro by a complex mechanism combining elements of 'immune complex,' drug adsorption, and autoantibody mechanisms. Drug-dependent hemolysis is a previously unreported but potentially serious complication of carboplatin therapy.

Original languageEnglish (US)
Pages (from-to)1016-1018
Number of pages3
JournalTransfusion
Volume36
Issue number11-12
StatePublished - Nov 1996
Externally publishedYes

Fingerprint

Carboplatin
Hemolytic Anemia
Coombs Test
Hemolysis
Injections
Antibodies
Pharmaceutical Preparations
Agglutination
Astrocytoma
Low Back Pain
Antigen-Antibody Complex
Serum
Intravenous Injections
Antineoplastic Agents
Autoantibodies
Cisplatin
Adsorption

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Hematology

Cite this

Marani, T. M., Trich, M. B., Armstrong, K. S., Ness, P. M., Smith, J., Minniti, C. P., & Sandler, S. G. (1996). Carboplatin-induced immune hemolytic anemia. Transfusion, 36(11-12), 1016-1018.

Carboplatin-induced immune hemolytic anemia. / Marani, T. M.; Trich, M. B.; Armstrong, K. S.; Ness, P. M.; Smith, J.; Minniti, Caterina P.; Sandler, S. G.

In: Transfusion, Vol. 36, No. 11-12, 11.1996, p. 1016-1018.

Research output: Contribution to journalArticle

Marani, TM, Trich, MB, Armstrong, KS, Ness, PM, Smith, J, Minniti, CP & Sandler, SG 1996, 'Carboplatin-induced immune hemolytic anemia', Transfusion, vol. 36, no. 11-12, pp. 1016-1018.
Marani TM, Trich MB, Armstrong KS, Ness PM, Smith J, Minniti CP et al. Carboplatin-induced immune hemolytic anemia. Transfusion. 1996 Nov;36(11-12):1016-1018.
Marani, T. M. ; Trich, M. B. ; Armstrong, K. S. ; Ness, P. M. ; Smith, J. ; Minniti, Caterina P. ; Sandler, S. G. / Carboplatin-induced immune hemolytic anemia. In: Transfusion. 1996 ; Vol. 36, No. 11-12. pp. 1016-1018.
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