Thrombocytopenia paclitaxel

Paclitaxel Taxol Carcinoma of the breast, ovaries Kaposi sarcoma nonsmall cell lung cancer Blood disorders (anemia, leukopenia, neutropenia, thrombocytopenia] hypersensitivity reaction (skin rash/itching, shortness of breath] joint/muscle pain peripheral neuropathies Gl distress (nausea, vomiting, diarrhea]... 

CYCLOPHOSPHAMIDE PACLITAXEL t risk of neutropenia, thrombocytopenia and mucositis when paditaxel is infused over 24 or 72 hours prior to cyclophosphamide Mechanism is uncertain Administer cyclophosphamide first and then follow with paditaxel... 

Bone marrow suppression is a dose-limiting adverse effect often encountered with paclitaxel. Neutropenia occurs most commonly 8-10 days after treatment, and recovery usually occurs on days 15-21. Paclitaxel is relatively platelet-sparing, and thrombocytopenia and anemia are rare (26). There is no evidence that neutropenia is cumulative, suggesting that paclitaxel may not irreversibly damage hemopoietic stem cells (1). 

Toxicity Paclitaxel causes neutropenia, thrombocytopenia, a high incidence of peripheral neuropathy, and possible hypersensitivity reactions during infusion. Docetaxel causes neurotoxicity and bone marrow depression. 

Kearns CM, Belani CP, Erkmen K, Zuhowski M, Hiponia D, Ergstrom C, Ramanthan R, Trenn M, Aisner J, Ergorin MJ, Reduced platelet toxicity with combination carboplatin paclitaxel pharmacodynamic modulation of carboplatin associated thrombocytopenia, Proc Am Soc Clin Oncol (1995) 14,170,... 

A study in patients given paclitaxel as a 24-hour infusion and cyclophosphamide as an infusion over 1 hour found that neutropenia and thrombocytopenia were more severe when paclitaxel preceded cyclophosphamide. Similarly, in another study, concurrent use of a continuous 72-hour infusion of paclitaxel and a daily bolus of cyclophosphamide had acceptable toxicity. However, when the cyclophosphamide was given as a single intravenous dose after the end of the 72-hour paelitaxel infusion, severe haematological and gastrointestinal toxieity occurred. Whether the clinical efficacy of this combination is also altered by the schedule and sequence has not been determined. See also Cyclophosphamide or Ifosfamide + Taxanes , p.628. 

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