Macrocytic Anemia during Low-dose Cisplatin and 5-Fluorouracil through Implanted Infusion Port for Unresectable Hepatobilliary Malignancies

Abstract

The efficacy of continuous arterial infusion chemotherapy through a subcutaneously implanted port has been reported with less adverse effects than systemic chemotherapy in hepatobilliary malignancies. However, macrocytic anemia is sometimes seen during this therapy. In 25 patients (22 with hepatocellular carcinoma, 3 with cholangiocellular carcinoma) treated with cisplatinum (10mg/day) and 5-Fluorouracil (5-FU) (250 mg/day), the frequency of anemia and its etiologies were evaluated. Moreover, the two groups (“anemia” and “no anemia” group) were compared with their backgrounds. Nine cases (36%) showed macrocytic anemia without any evident etiologies during therapy. The cumulative appearance rate of anemia was 19% at 12 weeks and 51% at 18 weeks. The Child-Pugh score or Japanese integrated staging (JIS) score were significantly higher in the “anemia” group than that in the “no anemia” group. Conclusion: Attention should be paid to slow progressive macrocytic anemia during low-dose cisplatinum and 5-FU, especially in patients with advanced liver cirrhosis.