[Splenomegaly Associated with FOLFOX Therapy]

Oxaliplatin is one of the key drugs for the treatment of colorectal cancer, although it is known to cause hepatic sinusoidal injury.

Thirty-one patients underwent modified FOLFOX6 therapy from April 2006 and December 2009 at our hospital. Four patients were excluded from this study because they had too many intervals in their therapeutic courses. The size of the spleen and the blood platelet count were analyzed before and after 6 months of FOLFOX therapy. The spleen was measured using CT scan, and the splenic index(SI=length×width×height)was evaluated.

After 6 months of treatment, the mean SI was increased from 229 cm3 to 323 cm3(p<0. 01). At the same time, the mean platelet count was decreased from 26. 9 ×10 / / 4 mm3 to 17. 1×104 mm3(p<0. 01). A negative correlation was found between the ratio of SI and the platelet count after 6 months of treatment to baseline(r=-0. 42, p=0. 030). SI increased by>50% in 12 patients (44. 4%). The platelet count decreased more severely in patients whose SI increased by>50%(p=0. 028).

Splenomegaly and thrombocytopenia were observed in patients who underwent FOLFOX therapy. These are candidate parameters for evaluating hepatic sinusoidal injury.