Abstract | OBJECTIVE: CASE SUMMARY: A 64-year-old white female had recently received treatment with bendamustine for stage III follicular lymphoma. After her fourth cycle, she was admitted to an outside facility with severe right upper quadrant pain across her back and findings consistent with obstructive jaundice. She was found to have pancytopenia and elevations in total bilirubin, alkaline phosphatase, and transaminase levels. A bone marrow biopsy showed no evidence of lymphoma and presence of megakaryocytes on 2 occasions. Upon transfer to West Virginia University Hospitals, her haptoglobin was found to be undetectable, total bilirubin 10.3 mg/dL (unconjugated bilirubin 4.9 mg/dL), reticulocyte count 21.4% (reticulocyte index > or = 2%), alkaline phosphatase 1125 U/L, and lactate dehydrogenase 421 U/L. The peripheral smear showed evidence of spherocytes and very rare schistocytes. Based on these findings, the woman was diagnosed with hemolytic anemia secondary to bendamustine exposure. She was started on prednisone 1 mg/kg (60 mg) daily and, soon after, her platelets and hemoglobin stabilized. DISCUSSION: CONCLUSIONS:
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Authors | Lisa E Glance, Aaron Cumpston, Abraham Kanate, Scot C Remick |
Journal | The Annals of pharmacotherapy
(Ann Pharmacother)
Vol. 43
Issue 11
Pg. 1903-6
(Nov 2009)
ISSN: 1542-6270 [Electronic] United States |
PMID | 19809007
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Nitrogen Mustard Compounds
- Bendamustine Hydrochloride
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Topics |
- Anemia, Hemolytic
(blood, chemically induced, diagnosis)
- Bendamustine Hydrochloride
- Female
- Humans
- Middle Aged
- Nitrogen Mustard Compounds
(adverse effects, blood)
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