Cisplatin Case Study

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Cisplatin is one of the most widely used antineoplastic agents in the treatment of solid tumor and hematological malignancies that may cause acute or chronic organ toxicity. Accidental overdose of cisplatin may occur despite all precautions and no general accepted guidelines for the treatment of such cases are available and no specific antidote for cisplatin exists. Here we report a 1-year-old girl who received a massive cisplatin overdose of 500 mg/m2 as an accidental substitution for carboplatin. Although aggressive treatment was given, the patient died because of severe renal failure and cardiac arrest. Our experience remind us to evaluate, establish and implement the best possible and accurate control mechanisms on different levels for…show more content…
The most serious complication is nephrotoxicity, which may result in irreversible renal failure. Key management strategies for a cisplatin overdose involve renal protection and enhancing drug elimination, and consideration of sodium thiosulfate and plasmapheresis. A suggested algorithmic approach for the initial management of a patient with a cisplatin over-dose is presented in figure 2. To our knowledge, patients inadvertently receiving less than 300 mg/ m2 of cisplatin reportedly often recover, whereas overdoses exceeding 400 mg/ m2 frequently result in death. To our knowledge, our case is the youngest one who received a high dose of cisplatin (500 mg/m2) in the absence of intravenous hydration, and nephrotoxicity result in renal failure, hearing loss, visual impairment, severe myelosuppression complicated by life-threatening sepsis were presented in this patient. Although vigorous therapies were given, the patient decreased. As the toxicity of cisplatin is dose-dependent, early elimination of the drug from plasma should be critical in the management. Most of the platinum in the blood plasma is bound to proteins within a few hours after intravenous administration. Binding of cisplatin to proteins and enzymes is generally believed to be the cause of its side effects, especially ototoxicity and…show more content…
heresis has been attributed to the removal of cisplatin-bound plasma proteins, and should nonetheless be strongly considered, regardless of time elapsed, in order to potentially reduce not only renal toxicities but also other
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