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Case Report

Thrombotic thrombocytopenic purpura following salvage chemotherapy with paclitaxel, ifosfamide and cisplatin in a patient with a refractory germ cell tumor: A case report and review of the literature

  • Authors:
    • Arife Ulas
    • Kamile Silay
    • Sema Akinci
    • Muhammed Bulent Akinci
    • Mehmet Ali Sendur
    • Didem Sener Dede
    • Yunus Halil Polat
    • Bulent Yalcin
  • View Affiliations / Copyright

    Affiliations: Department of Medical Oncology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey, Department of Geriatrics, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey, Department of Hematology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey, Department of Medical Oncology, Yildirim Beyazit University, Ankara, Turkey, Department of Internal Medicine, Yildirim Beyazit University, Ankara, Turkey
  • Pages: 2223-2226
    |
    Published online on: June 8, 2015
       https://doi.org/10.3892/ol.2015.3338
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Abstract

Thrombotic thrombocytopenic purpura (TTP) is a rare form of thrombotic microangiopathy that is characterized by microvascular thrombosis, thrombocytopenia, hemolysis and end organ damage. An extensive variety of drugs, including certain chemotherapeutic agents, have been associated with TTP. However, paclitaxel, cisplatin and ifosfamide regimen (TIP)‑induced TTP has not previously been described. The present study reports the case of a 43‑year‑old patient with a refractory testicular germ cell tumor who developed acute TTP during TIP chemotherapy. Following the third cycle of TIP chemotherapy, the patient developed fever, anemia, thrombocytopenia and confusion. A diagnosis of TTP was established. Plasmapheresis was initiated as daily treatment in the first week, then continued every other day for 4 weeks. TIP chemotherapy was discontinued. The patient's clinical and neurological symptoms improved markedly after a week. Renal function and hemolysis improved, and the patient was discharged in a stable condition. The patient did not develop any complications and has been in remission for 5 months. The Naranjo adverse drug reaction probability scale indicated a likely association between TTP and the TIP chemotherapy regimen in this patient. This case is also investigated with regard to the associated literature to increase the awareness of TTP following chemotherapy.
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Copy and paste a formatted citation
Spandidos Publications style
Ulas A, Silay K, Akinci S, Akinci MB, Sendur MA, Dede DS, Polat YH and Yalcin B: Thrombotic thrombocytopenic purpura following salvage chemotherapy with paclitaxel, ifosfamide and cisplatin in a patient with a refractory germ cell tumor: A case report and review of the literature. Oncol Lett 10: 2223-2226, 2015.
APA
Ulas, A., Silay, K., Akinci, S., Akinci, M.B., Sendur, M.A., Dede, D.S. ... Yalcin, B. (2015). Thrombotic thrombocytopenic purpura following salvage chemotherapy with paclitaxel, ifosfamide and cisplatin in a patient with a refractory germ cell tumor: A case report and review of the literature. Oncology Letters, 10, 2223-2226. https://doi.org/10.3892/ol.2015.3338
MLA
Ulas, A., Silay, K., Akinci, S., Akinci, M. B., Sendur, M. A., Dede, D. S., Polat, Y. H., Yalcin, B."Thrombotic thrombocytopenic purpura following salvage chemotherapy with paclitaxel, ifosfamide and cisplatin in a patient with a refractory germ cell tumor: A case report and review of the literature". Oncology Letters 10.4 (2015): 2223-2226.
Chicago
Ulas, A., Silay, K., Akinci, S., Akinci, M. B., Sendur, M. A., Dede, D. S., Polat, Y. H., Yalcin, B."Thrombotic thrombocytopenic purpura following salvage chemotherapy with paclitaxel, ifosfamide and cisplatin in a patient with a refractory germ cell tumor: A case report and review of the literature". Oncology Letters 10, no. 4 (2015): 2223-2226. https://doi.org/10.3892/ol.2015.3338
Copy and paste a formatted citation
x
Spandidos Publications style
Ulas A, Silay K, Akinci S, Akinci MB, Sendur MA, Dede DS, Polat YH and Yalcin B: Thrombotic thrombocytopenic purpura following salvage chemotherapy with paclitaxel, ifosfamide and cisplatin in a patient with a refractory germ cell tumor: A case report and review of the literature. Oncol Lett 10: 2223-2226, 2015.
APA
Ulas, A., Silay, K., Akinci, S., Akinci, M.B., Sendur, M.A., Dede, D.S. ... Yalcin, B. (2015). Thrombotic thrombocytopenic purpura following salvage chemotherapy with paclitaxel, ifosfamide and cisplatin in a patient with a refractory germ cell tumor: A case report and review of the literature. Oncology Letters, 10, 2223-2226. https://doi.org/10.3892/ol.2015.3338
MLA
Ulas, A., Silay, K., Akinci, S., Akinci, M. B., Sendur, M. A., Dede, D. S., Polat, Y. H., Yalcin, B."Thrombotic thrombocytopenic purpura following salvage chemotherapy with paclitaxel, ifosfamide and cisplatin in a patient with a refractory germ cell tumor: A case report and review of the literature". Oncology Letters 10.4 (2015): 2223-2226.
Chicago
Ulas, A., Silay, K., Akinci, S., Akinci, M. B., Sendur, M. A., Dede, D. S., Polat, Y. H., Yalcin, B."Thrombotic thrombocytopenic purpura following salvage chemotherapy with paclitaxel, ifosfamide and cisplatin in a patient with a refractory germ cell tumor: A case report and review of the literature". Oncology Letters 10, no. 4 (2015): 2223-2226. https://doi.org/10.3892/ol.2015.3338
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