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A Rare Toxicity to Chemotherapy

The use of chemotherapy is often limited by toxic side-effects caused to healthy cells. In general, most chemotherapy treatments cause DNA damage or stop cells in mitosis, targeting both cancer and healthy cells. Life-threatening toxicities of chemotherapies can occur with varying frequency depending on the agent suspected and underlying patient risk factors. Post-chemotherapy fatal toxicity is comparatively rare. They occur mostly after high-dose chemotherapy. Pharmacogenomics is a potential and growing field of research that can help in the individualization of therapy based on responses and toxicity. We report a case of a young man with a carcinoma of the right upper alveolus. He was started on weekly chemoradiation with low-dose cisplatinum. After the second cycle, he developed persistent pancytopenia, which never recovered after 3 weeks of admission in the hospital for supportive care. This case highlights the importance of pharmacogenomics in medical oncology. It can also help in counseling the patient and relatives, especially when there is a high degree of suspicion of an elevated amount of toxicities. There has been considerable research into pharmacogenomics in the past decade, and functional genomic approaches are likely to be used in future as an important resource for the prediction of clinical outcome.