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Immune thrombocytopenia as a paraneoplastic syndrome in patients with nasopharyngeal cancer

Authors

  • Kunyu Yang MD,

    1. Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
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  • Tao Zhang MD,

    1. Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
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  • Jing Chen MD,

    1. Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
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  • Li Fan MD,

    1. Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
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  • Zhongyuan Yin MD,

    1. Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
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  • Yu Hu MD, PhD,

    Corresponding author
    1. Department and Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
    • Department and Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
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  • Gang Wu MD, PhD

    Corresponding author
    1. Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
    • Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
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Abstract

Background

Nasopharyngeal cancer (NPC) presenting with thrombocytopenia is rare. This report details 2 cases of NPC with grade III thrombocytopenia as a paraneoplastic syndrome.

Methods

We present 2 cases of NPC in whom grade III thrombocytopenia was diagnosed concurrently at presentation. One patient underwent definitive intensity-modulated radiation therapy (IMRT) in combination with concurrent cetuximab, the other with cisplatin. Both patients received adjuvant chemotherapy composed of docetaxel and cisplatin.

Results

The cause of their grade III thrombocytopenia was diagnosed as immunologic in origin. Prednisone was administered before IMRT, and their peripheral platelet counts recovered to normal levels. Their platelet counts fell below normal levels several times during their treatment. However, their radiotherapy and chemotherapy had never been interrupted due to thrombocytopenia.

Conclusion

Grade III thrombocytopenia is a rare paraneoplastic syndrome in patients with NPC. These patients can tolerate the aggressive definitive management of radiotherapy and chemotherapy with supportive care. © 2010 Wiley Periodicals, Inc. Head Neck, 2012

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