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Quadruple-Checkerboard: A Modification of the Three-Dimensional Checkerboard for Studying Drug Combinations

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Old drugs: new complications.

Sandeep Batra¹, Jyoti Wadhwa, Ashok K Vaid

¹Department of Medical Oncology, Medanta, The Medicity, Gurgaon, Haryana, India. sandeepriya2000@yahoo.com

BMJ Case Reports

|January 25, 2013

Summary

This case report details acute splenic and bilateral renal infarction in a non-small cell lung cancer patient undergoing gemcitabine and cisplatin chemotherapy. This rare complication, involving both spleen and kidneys, requires consideration in patients with severe abdominal pain.

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Published on: December 11, 2016

Area of Science:

Oncology
Nephrology
Radiology

Background:

Non-small cell lung carcinoma (NSCLC) is a leading cause of cancer-related mortality.
Chemotherapy regimens, including gemcitabine and cisplatin, are standard treatments for NSCLC.
Vascular complications are potential adverse events associated with chemotherapy.

Observation:

A patient with NSCLC developed acute splenic and bilateral renal infarction during treatment with gemcitabine and cisplatin.
This presentation of combined splenic and renal infarction is novel, with only one prior report of bilateral renal infarction with this regimen.
Symptoms included severe abdominal pain and backache.

Findings:

The case highlights a rare but serious adverse event of gemcitabine and cisplatin chemotherapy.
Splenic infarction in conjunction with bilateral renal infarction has not been previously documented.
The findings underscore the potential for multi-organ vascular compromise.

Implications:

Clinicians should consider splenic and renal infarction in the differential diagnosis for patients on gemcitabine-based and cisplatin-based chemotherapy presenting with severe abdominal or back pain.
Early recognition and management of infarction are crucial for patient outcomes.
Further research into the mechanisms and risk factors for chemotherapy-induced vascular events is warranted.