PMC2837905_01
Plasma cisplatin concentrations, leukocyte counts, Ccr values and platinum clearance values. (a) An open diamond and arrow heads denote for dialysis and plasma exchange, respectively. (b) Note that cisplatin clearance approximately correlated with Ccr. WBC: white blood cell, G-CSF: granurocyte-colony-stimulating factor, Ccr: creatinine clearance.
CRM2010-802312.001.jpg
PMC2837905_01_CRM2010-802312.001.jpg
fig1
Tuesday, the patient complained that he had hearing difficulty, and the cisplatin overdose was noted, and further chemotherapy was disrupted (Figure 1(a)). The patient was immediately transferred into a laminar flow clean room. Hemodialysis and detoxification with sodium thiosulfate (STS) were performed on the same day and emergency plasma exchange was implemented on day 5 (Figure 1(a)).  On days 5 through 19, the patient underwent plasma exchange seven times and his plasma cisplatin concentration decreased to 110 ng/mL (Figure 1(a)). It was noted that his plasma cisplatin concentration was abruptly decreased after 2 cycles of plasma exchange; however, despite daily plasma exchange conducted, an increase of cisplatin concentration was observed twice, on days 8 and 10 (Figure 1(a)).  On day 14, he developed high fever with infectious focuses unknown and his granulocyte counts were of ~10/muL, which persisted over 3 days despite the G-CSF administration (Figure 1(a)).