Sudden onset of thrombocytopenia after the treatment with chemotherapeutic agent(s) in a patient with lymphangitis carcinomatosa.

Cisplatin (CDDP 100 mg/m2, div), adriamycin (ADR 20 mg/body, iv) and futrafur-uracil conjugate (UFT 200 mg/day, po) were administered on the same day to a 51-year-old housewife with lymphangitis carcinomatosa of the lung. During the CDDP infusion, the patient unexpectedly became highly febrile. On the following day, the patient developed purpura on the upper and lower extremities, and her platelet count was 3.2 x 10(4)/mm3 in spite of being 32.4 x 10(4)/mm3 on the day before chemotherapy. The platelet count recovered to 9.4 x 10(4)/mm3 on day 3, and increased to a maximum of 56.1 x 10(4)/mm3 on day 20. Previously, we had treated several patients with adenocarcinoma by the same protocol, but never experienced such a case that developed a sudden fall in their platelet count. Although the true mechanisms remain to be solved, this case is very interesting from a standpoint of drug-induced thrombocytopenia.