Acute therapy-related myelodysplastic syndromes following capecitabine and oxaliplatin therapy in gastric malignant tumor: A case report

Abstract

Rational: Patients with gastric cancer show a relatively low incidence of developing secondary myelodysplastic syndrome (MDS). Patient concerns: A 60-year-old man was admitted because of pain and discomfort in the upper abdomen and intermittent abdominal pain. Diagnoses: Ulcerative moderately poorly differentiated adenocarcinoma (pT2N2M0G3, stage IIB) and MDS. Interventions: The patient underwent chemotherapy with oxaliplatin (OXP, intravenously guttae on day 1) plus capecitabine (CAP, bis in die orally on day 1–14). The patient developed degree III myelosuppression after OXP plus CAP chemotherapy and MDS was subsequently confirmed by diagnosis of the bone marrow biopsy. Temporary but significant hematological improvements were observed after the patient received corresponding treatment, which helped achieve remission and improve pancytopenia. Outcomes: The patient presented partial remission after corresponding treatment and no other complications have been recorded. Lessons: Acute MDS is an unusual adverse effect induced by OXP plus CAP chemotherapy. It is urgent to suggest implementing a supplementary assessment or examination for patients receiving these therapies in future cases.