奥拉帕利相关骨髓增生异常综合征  

Myelodysplastic syndrome associated with olaparib

作　　者：姚海荣[1] 刘世凯[1] Yao Hairong;Liu Shikai(Third Department of Gynaecology,Cangzhou Central Hospital,Hebei Province,Cangzhou 061000,China)

机构地区：[1]沧州市中心医院妇三科,沧州061000

出　　处：《药物不良反应杂志》2023年第11期702-704,共3页Adverse Drug Reactions Journal

摘　　要：1例58岁女性患者因卵巢高级别浆液性癌ⅣB期行卵巢癌肿瘤细胞减灭术后3年余,先后给予紫杉醇+卡铂方案化疗6个疗程、多柔比星脂质体+卡铂方案化疗6个疗程治疗。后续给予奥拉帕利300 mg口服、2次/d维持治疗,25 d后患者因出现Ⅱ度骨髓抑制,奥拉帕利减量至早150 mg、晚300 mg口服。13个月后患者出现全血细胞减少,血小板最低至2×10^(9)/L。立即停用奥拉帕利,给予输注悬浮红细胞、新鲜单采血小板,升白细胞、补铁及升血小板等治疗后效果不明显,骨髓流式细胞检测结果提示骨髓增生异常综合征可能性大。停用奥拉帕利47 d后患者因腹盆腔大出血、失血性休克致循环衰竭死亡。A 58‑year‑old female patient underwent ovarian cancer tumor cell reduction surgery for advanced ovarian serous carcinoma in stageⅣB for more than 3 years and received chemotherapy with paclitaxel and carboplatin regimen for a total of 6 cycles and chemotherapy with doxorubicin liposome and carboplatin regimen for a total of 6 cycles successively.After that,olaparib 300 mg was administered twice daily orally for maintenance treatment.Twenty-five days later,due to the occurrence of gradeⅡbone marrow suppression in the patient,the dose of olaparib was reduced to 150 mg in the morning and 300 mg in the evening.After 13 months of olaparib treatment,the patient developed pancytopenia,with the lowest platelet count of 2×10^(9)/L.Olaparib was stopped immediately.The symptomatic and supportive treatments such as infusion of suspended red blood cells and fresh platelets,elevation of white blood cells,iron replenishment,and platelet elevation were given,but the efficacy was not obvious.Bone marrow flow cytometry detection suggested a high possibility of myelodysplastic syndrome.After discontinuing olaparib for 47 days,the patient died of circulatory failure due to massive abdominal and pelvic bleeding and hemorrhagic shock.

关 键 词：卵巢肿瘤 骨髓增生异常综合征 聚腺苷二磷酸核糖聚合酶抑制剂 奥拉帕利 

分 类 号：R979.1[医药卫生—药品]