CASE REPORT article
Front. Pharmacol.
Sec. Pharmacology of Anti-Cancer Drugs
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1668180
Life-Threatening Cisplatin-Induced Myelosuppression in Pediatric Osteosarcoma: Molecular Mechanisms, Pharmacogenomic Profiling, and Targeted Clinical Management
Provisionally accepted
- 1West China Hospital of Sichuan University-Ziyang Hospital, Ziyang, China
- 2Ziyang Central Hospital, Ziyang, China
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Abstract A 10-year-old female with osteoblastic osteosarcoma developed life-threatening cisplatin-induced myelosuppression (grade IV neutropenia/thrombocytopenia) following the 8th cycle of MAP chemotherapy. Critical pharmacological findings include a cumulative cisplatin dose of 720 mg/m ² exceeding the pediatric safety threshold of 400 mg/m ² . The CYP3A5*1/*1 genotype prolonged the half-life of cisplatin to 8.2 hours. Cisplatin-specific biomarkers included serum magnesium 1.2 mg/dL and urinary N-acetyl-β -D-glucosaminidase 48 U/L. Targeted interventions (G-CSF, romiplostim,meropenem) led to hematological recovery within 14 days. This case implicates cisplatin overdose with impaired metabolic clearance as the primary toxicity mechanism.
Keywords: cisplatin-induced myelosuppression, Osteosarcoma, pharmacogenomics, CYP3A5, Toxicity monitoring, pediatric oncology
Received: 17 Jul 2025; Accepted: 15 Sep 2025.
Copyright: © 2025 Dai, Zhang, Zhang and Dong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chuanqiang Dai, 59490003@qq.com
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