Rash and neutropenia after the administration of oxaliplatin and 5-fluorouracil plus calcium folinate injection: a case report

Ann Palliat Med. 2020 Sep;9(5):3678-3683. doi: 10.21037/apm-20-1321. Epub 2020 Aug 31.

Abstract

A 56-year-old male patient was admitted due to a "rectal malignant tumor". He suffered from rash and neutropenia after multiple chemotherapy sessions including oxaliplatin, 5-fluorouracil (5- FU), and calcium folinate injection (CF) which are called FOLFOX regimen for short. The rash was treated with methylprednisolone + promethazine + calcium gluconate, and the neutropenia was treated by subcutaneous injection of the Recombinant Human Granulocyte Colony-Stimulating Factor Injection, the symptoms were relieved. Moreover, rashes and neutropenia are known common adverse reactions after intravenous administration of FOLFOX regimen. Based on the patient's symptoms and the timing of drug administration, a diagnosis of "rash and neutropenia due to the use of FOLFOX regimen" was made. Oxaliplatin and CF may also cause allergic reactions, including skin erythema and anaphylactic shock, etc. Once allergic reaction occurs, the fatality rate is higher than that of Penicillin. Therefore, sufficient attention should be paid to the patients reported in this paper who received FOLFOX regimen for multiple times and had multiple rashes and adverse reactions of neutropenia. Medical staff should closely monitored the adverse reactions and changes in vital signs of patients treated with this regimen during chemotherapy, and the chemotherapy regimen should be adjusted or terminated when necessary. The adverse reactions reported in this article deserve clinical attention.

Keywords: 5-fluorouracil (5-FU); Oxaliplatin; calcium folinate injection (CF); case report; neutropenia; rash.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Exanthema* / chemically induced
  • Fluorouracil / adverse effects*
  • Humans
  • Leucovorin / adverse effects
  • Male
  • Middle Aged
  • Neutropenia* / chemically induced
  • Oxaliplatin / adverse effects*
  • Treatment Outcome

Substances

  • Oxaliplatin
  • Leucovorin
  • Fluorouracil