Hematologic Effect of cis-Platinum-Bleomycin Therapy

Abstract

A prospective study of the hematologic findings in 19 patients receiving cis-platinum (C-P) bleomycin (B) for squamous cell carcinoma of the head and neck was performed. CP 3 mg/kg was given on day 1, B 15 mg/m² on day 3 and then by continous infusion from day 3 to 10. Hematocrits declined in all patients from a mean of 41.6 ± 3.9 to 36.6 ± 4.9 (p < 0.001) with the nadir seen by 10 days, reticulocyte count was unchanged. In 1 patient marked hemolysis occurred over 10-day period associated with the appearance of irregular spherocytes on smear, a situation similar to the index case which initiated this study. 5 other patients had spherocytes. A significant lymphopenia in the absence of neutropenia and thrombocytopenia was also observed.

The Effects of Cisplatin on Normal Human Erythrocytes in Vitro

“…Cisplatin binds avidly to red cell membranes (20) although, in a recent examination of erythrocyte morphology, Najarian et a1 (6) found no evidence of any alteration induced by this drug in vitro. However, these investigators gave no details of the experimental methods they employed, and a significant change in the distribution of red cell shapes was observed in the current studies using therapeutic concentrations of the agent in whole blood.…”