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Case Reports in Medicine
Volume 2010 (2010), Article ID 802312, 4 pages
http://dx.doi.org/10.1155/2010/802312
Case Report

Successful Treatment of Cisplatin Overdose with Plasma Exchange

1Department of Hematology & Infectious Diseases, Kumamoto University School of Medicine, Kumamoto 860-8556, Japan
2Department of Gastroenterological Surgery, Kumamoto University School of Medicine, Kumamoto 860-8556, Japan

Received 2 December 2009; Revised 27 January 2010; Accepted 27 January 2010

Academic Editor: Mohammad Abdollahi

Copyright © 2010 Yasuhiro Yamada et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Accidental cisplatin overdose has been occurring with an increasing frequency due to expanding usage of the agent. However, the optimal strategy to treat such patients remains to be established. Here, we report a case of large cisplatin overdose, successfully managed by plasma exchange, intravenous hydration, granulocyte colony-stimulating factor (G-CSF) administration, and other supportive care. A 67-year-old man with esophageal carcinoma received a large cisplatin overdose of 240  m g / m 2 , when he received adjuvant therapy following subtotal esophagectomy. On day 4, he experienced frank cisplatin toxicities and emergency plasma exchange was initiated. With 7 cycles of plasma exchange, the cisplatin concentration decreased from 2,350 to 110 ng/mL. Severe bone marrow suppression with high fever ensued on day 10, which was successfully treated with G-CSF and antibiotics. Despite moderate hearing sense reduction, he recovered without significant complications. Immediate plasma exchange with hydration and other care was efficacious in quickly lowering cisplatin concentrations.