Carboplatin Induced Fatal Autoimmune Hemolytic Anemia: First Reported Case

Area of Science:

• Oncology
• Hematology
• Clinical Pharmacology

Background:

• Carboplatin is a widely used platinum-based chemotherapy agent for various cancers.
• Autoimmune hemolytic anemia (AIHA) is a known, though rare, adverse effect of Carboplatin treatment.
• Previous reports indicate AIHA associated with Carboplatin is typically nonfatal and reversible upon drug discontinuation.

Observation:

• A 77-year-old female patient with recurrent endometrial adenocarcinoma developed acute AIHA during her fifth cycle of Carboplatin and Paclitaxel chemotherapy.
• The patient collapsed during Carboplatin infusion and expired within seven hours despite medical intervention.
• Diagnostic tests revealed a positive direct Coomb's test and detection of Carboplatin-dependent antibodies.

Findings:

• The patient experienced a fatal episode of Carboplatin-induced autoimmune hemolytic anemia.
• This case represents a rare instance of fatal autoimmune hemolysis linked to Carboplatin therapy.
• The rapid and fatal progression of AIHA in this patient is unusual compared to previously reported cases.

Implications:

• Clinicians should maintain a high index of suspicion for AIHA in patients receiving Carboplatin, especially with a sudden drop in hemoglobin levels.
• This case underscores the potential for severe, life-threatening adverse reactions to Carboplatin, even in patients with prior tolerance.
• Prompt recognition and management of suspected Carboplatin-induced AIHA are critical due to its potential for rapid deterioration and fatality.