A castrate-resistant metastatic prostate cancer patient with severe pancytopenia, successfully treated with docetaxel chemotherapy
Introduction Prognosis of metastatic castrate-resistant prostate cancer is poor with a median survival of 12 to 36 months. Bone metastasis is common, and bone marrow metastasis occurs later in the disease course. The median survival in these patients after bone marrow involvement is less than six mo...
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| Veröffentlicht in: | Journal of oncology pharmacy practice 2020-07, Vol.26 (5), p.1254-1258 |
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| container_title | Journal of oncology pharmacy practice |
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| creator | Kunthur, Anuradha |
| description | Introduction
Prognosis of metastatic castrate-resistant prostate cancer is poor with a median survival of 12 to 36 months. Bone metastasis is common, and bone marrow metastasis occurs later in the disease course. The median survival in these patients after bone marrow involvement is less than six months. We report a case of castrate-resistant prostate cancer patient presented with severe pancytopenia due to bone marrow involvement of prostate cancer, treated successfully with docetaxel chemotherapy. Post chemotherapy, the patient became transfusion independent and prostate-specific antigen improved to 0.1 ng/ml from 1051 ng/ml.
Case report
A 70-year-old gentleman with a history of metastatic prostate cancer on androgen deprivation therapy and polycythemia vera presented to emergency room with dizziness and melena. Workup revealed severe pancytopenia with platelet count of 12k and hemoglobin of 4.5 gm/dl. Bone marrow biopsy confirmed diffuse involvement of bone marrow with prostate cancer. Prostate-specific antigen was 1051 gm/dl.
Management and outcome: The patient received 14 units of packed red blood cell, 10 units of platelet transfusion within one week. Docetaxel chemotherapy was started along with thrombopoietin agonist romiplostim and pegylated filgrastim. He received five cycles of docetaxel treatment. Post chemotherapy, the patient became transfusion independent and prostate-specific antigen improved to 1.17 ng/ml from 1051 ng/ml. The patient is still alive one year after the presentation with good quality of life and the prostate-specific antigen further improved to 0.1 ng/dl.
Conclusion
This case suggests that selected patients with severe pancytopenia, due to bone marrow infiltration of prostate cancer, can be treated with docetaxel chemotherapy and romiplostim support with significant response. Docetaxel treatment may be beneficial to unpack the marrow and for quicker response in patients with good performance status. |
| doi_str_mv | 10.1177/1078155219890653 |
| format | Article |
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Prognosis of metastatic castrate-resistant prostate cancer is poor with a median survival of 12 to 36 months. Bone metastasis is common, and bone marrow metastasis occurs later in the disease course. The median survival in these patients after bone marrow involvement is less than six months. We report a case of castrate-resistant prostate cancer patient presented with severe pancytopenia due to bone marrow involvement of prostate cancer, treated successfully with docetaxel chemotherapy. Post chemotherapy, the patient became transfusion independent and prostate-specific antigen improved to 0.1 ng/ml from 1051 ng/ml.
Case report
A 70-year-old gentleman with a history of metastatic prostate cancer on androgen deprivation therapy and polycythemia vera presented to emergency room with dizziness and melena. Workup revealed severe pancytopenia with platelet count of 12k and hemoglobin of 4.5 gm/dl. Bone marrow biopsy confirmed diffuse involvement of bone marrow with prostate cancer. Prostate-specific antigen was 1051 gm/dl.
Management and outcome: The patient received 14 units of packed red blood cell, 10 units of platelet transfusion within one week. Docetaxel chemotherapy was started along with thrombopoietin agonist romiplostim and pegylated filgrastim. He received five cycles of docetaxel treatment. Post chemotherapy, the patient became transfusion independent and prostate-specific antigen improved to 1.17 ng/ml from 1051 ng/ml. The patient is still alive one year after the presentation with good quality of life and the prostate-specific antigen further improved to 0.1 ng/dl.
Conclusion
This case suggests that selected patients with severe pancytopenia, due to bone marrow infiltration of prostate cancer, can be treated with docetaxel chemotherapy and romiplostim support with significant response. Docetaxel treatment may be beneficial to unpack the marrow and for quicker response in patients with good performance status.</description><identifier>ISSN: 1078-1552</identifier><identifier>EISSN: 1477-092X</identifier><identifier>DOI: 10.1177/1078155219890653</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Antigen presentation ; Antigens ; Biopsy ; Bone cancer ; Bone marrow ; Cancer therapies ; Case reports ; Chemotherapy ; Emergency medical care ; Erythrocytes ; Hemoglobin ; Medical prognosis ; Metastases ; Metastasis ; Pancytopenia ; Patients ; Platelets ; Polycythemia ; Polycythemia vera ; Prostate cancer ; Prostate-specific antigen ; Quality of life ; Thrombopoietin</subject><ispartof>Journal of oncology pharmacy practice, 2020-07, Vol.26 (5), p.1254-1258</ispartof><rights>The Author(s) 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c342t-da6601aadbbc7039a6f15932ac8a7dae98a02fa2d341a2acf5e1857a8d83b1a3</citedby><cites>FETCH-LOGICAL-c342t-da6601aadbbc7039a6f15932ac8a7dae98a02fa2d341a2acf5e1857a8d83b1a3</cites><orcidid>0000-0002-6962-4546</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1078155219890653$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1078155219890653$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids></links><search><creatorcontrib>Kunthur, Anuradha</creatorcontrib><title>A castrate-resistant metastatic prostate cancer patient with severe pancytopenia, successfully treated with docetaxel chemotherapy</title><title>Journal of oncology pharmacy practice</title><description>Introduction
Prognosis of metastatic castrate-resistant prostate cancer is poor with a median survival of 12 to 36 months. Bone metastasis is common, and bone marrow metastasis occurs later in the disease course. The median survival in these patients after bone marrow involvement is less than six months. We report a case of castrate-resistant prostate cancer patient presented with severe pancytopenia due to bone marrow involvement of prostate cancer, treated successfully with docetaxel chemotherapy. Post chemotherapy, the patient became transfusion independent and prostate-specific antigen improved to 0.1 ng/ml from 1051 ng/ml.
Case report
A 70-year-old gentleman with a history of metastatic prostate cancer on androgen deprivation therapy and polycythemia vera presented to emergency room with dizziness and melena. Workup revealed severe pancytopenia with platelet count of 12k and hemoglobin of 4.5 gm/dl. Bone marrow biopsy confirmed diffuse involvement of bone marrow with prostate cancer. Prostate-specific antigen was 1051 gm/dl.
Management and outcome: The patient received 14 units of packed red blood cell, 10 units of platelet transfusion within one week. Docetaxel chemotherapy was started along with thrombopoietin agonist romiplostim and pegylated filgrastim. He received five cycles of docetaxel treatment. Post chemotherapy, the patient became transfusion independent and prostate-specific antigen improved to 1.17 ng/ml from 1051 ng/ml. The patient is still alive one year after the presentation with good quality of life and the prostate-specific antigen further improved to 0.1 ng/dl.
Conclusion
This case suggests that selected patients with severe pancytopenia, due to bone marrow infiltration of prostate cancer, can be treated with docetaxel chemotherapy and romiplostim support with significant response. Docetaxel treatment may be beneficial to unpack the marrow and for quicker response in patients with good performance status.</description><subject>Antigen presentation</subject><subject>Antigens</subject><subject>Biopsy</subject><subject>Bone cancer</subject><subject>Bone marrow</subject><subject>Cancer therapies</subject><subject>Case reports</subject><subject>Chemotherapy</subject><subject>Emergency medical care</subject><subject>Erythrocytes</subject><subject>Hemoglobin</subject><subject>Medical prognosis</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Pancytopenia</subject><subject>Patients</subject><subject>Platelets</subject><subject>Polycythemia</subject><subject>Polycythemia vera</subject><subject>Prostate cancer</subject><subject>Prostate-specific antigen</subject><subject>Quality of life</subject><subject>Thrombopoietin</subject><issn>1078-1552</issn><issn>1477-092X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kctLxDAQxoMouK7ePRa8eLCaR9Okx2XxBQte9uCtzKZTt0tfJqnaq3-5WSoIC54yfPP7PmYyhFwyesuYUneMKs2k5CzTGU2lOCIzligV04y_Hoc6tON9_5ScObejlGrF9Yx8LyIDzlvwGFt0lfPQ-qhBH0TwlYl62-0rDFhr0EZ9UDEgn5XfRg4_0GLQWjP6rse2gpvIDcagc-VQ12PkLQZzMeFFZ0LwF9aR2WLT-S1a6MdzclJC7fDi952T9cP9evkUr14en5eLVWxEwn1cQJpSBlBsNkZRkUFaMpkJDkaDKgAzDZSXwAuRMAhqKZFpqUAXWmwYiDm5nmLDRu8DOp83lTNY19BiN7icC5ZJylLJAnp1gO66wbZhuJwnXCSpoioNFJ0oE77IWSzz3lYN2DFnNN_fJD-8SbDEk8XBG_6F_sv_AHaJj3c</recordid><startdate>202007</startdate><enddate>202007</enddate><creator>Kunthur, Anuradha</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TO</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6962-4546</orcidid></search><sort><creationdate>202007</creationdate><title>A castrate-resistant metastatic prostate cancer patient with severe pancytopenia, successfully treated with docetaxel chemotherapy</title><author>Kunthur, Anuradha</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c342t-da6601aadbbc7039a6f15932ac8a7dae98a02fa2d341a2acf5e1857a8d83b1a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Antigen presentation</topic><topic>Antigens</topic><topic>Biopsy</topic><topic>Bone cancer</topic><topic>Bone marrow</topic><topic>Cancer therapies</topic><topic>Case reports</topic><topic>Chemotherapy</topic><topic>Emergency medical care</topic><topic>Erythrocytes</topic><topic>Hemoglobin</topic><topic>Medical prognosis</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Pancytopenia</topic><topic>Patients</topic><topic>Platelets</topic><topic>Polycythemia</topic><topic>Polycythemia vera</topic><topic>Prostate cancer</topic><topic>Prostate-specific antigen</topic><topic>Quality of life</topic><topic>Thrombopoietin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kunthur, Anuradha</creatorcontrib><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of oncology pharmacy practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kunthur, Anuradha</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A castrate-resistant metastatic prostate cancer patient with severe pancytopenia, successfully treated with docetaxel chemotherapy</atitle><jtitle>Journal of oncology pharmacy practice</jtitle><date>2020-07</date><risdate>2020</risdate><volume>26</volume><issue>5</issue><spage>1254</spage><epage>1258</epage><pages>1254-1258</pages><issn>1078-1552</issn><eissn>1477-092X</eissn><abstract>Introduction
Prognosis of metastatic castrate-resistant prostate cancer is poor with a median survival of 12 to 36 months. Bone metastasis is common, and bone marrow metastasis occurs later in the disease course. The median survival in these patients after bone marrow involvement is less than six months. We report a case of castrate-resistant prostate cancer patient presented with severe pancytopenia due to bone marrow involvement of prostate cancer, treated successfully with docetaxel chemotherapy. Post chemotherapy, the patient became transfusion independent and prostate-specific antigen improved to 0.1 ng/ml from 1051 ng/ml.
Case report
A 70-year-old gentleman with a history of metastatic prostate cancer on androgen deprivation therapy and polycythemia vera presented to emergency room with dizziness and melena. Workup revealed severe pancytopenia with platelet count of 12k and hemoglobin of 4.5 gm/dl. Bone marrow biopsy confirmed diffuse involvement of bone marrow with prostate cancer. Prostate-specific antigen was 1051 gm/dl.
Management and outcome: The patient received 14 units of packed red blood cell, 10 units of platelet transfusion within one week. Docetaxel chemotherapy was started along with thrombopoietin agonist romiplostim and pegylated filgrastim. He received five cycles of docetaxel treatment. Post chemotherapy, the patient became transfusion independent and prostate-specific antigen improved to 1.17 ng/ml from 1051 ng/ml. The patient is still alive one year after the presentation with good quality of life and the prostate-specific antigen further improved to 0.1 ng/dl.
Conclusion
This case suggests that selected patients with severe pancytopenia, due to bone marrow infiltration of prostate cancer, can be treated with docetaxel chemotherapy and romiplostim support with significant response. Docetaxel treatment may be beneficial to unpack the marrow and for quicker response in patients with good performance status.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><doi>10.1177/1078155219890653</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-6962-4546</orcidid></addata></record> |
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| subjects | Antigen presentation Antigens Biopsy Bone cancer Bone marrow Cancer therapies Case reports Chemotherapy Emergency medical care Erythrocytes Hemoglobin Medical prognosis Metastases Metastasis Pancytopenia Patients Platelets Polycythemia Polycythemia vera Prostate cancer Prostate-specific antigen Quality of life Thrombopoietin |
| title | A castrate-resistant metastatic prostate cancer patient with severe pancytopenia, successfully treated with docetaxel chemotherapy |
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