Oxaliplatin causing splenomegaly (enlarged spleen)...???

[scmguru]

Folks,

I am Stage IV with non-resectable meths in the liver and a very small nodule in one lung. I was started FOLFOX-6 + Avastin last October. Progress was good. My CEA dropped from 22 to 2.2 and my liver chemistry started normalizing by January. CAT scans showed generalized reduction of the size of my liver tumors and stability of the lung nodule.

However, around the 10th FOLFOX cycle (this past March) I had developed thrombocytopenia (low platelet count). Moreover, a CAT in late April showed that my spleen had enlarged big time (splenomegaly). I was told by my Doctor in Sloan-Kettering that the cause of my splenomegaly and, thus, my low platelet count, was the Oxaliplatin. I was told to continue with the treatment without Oxaliplatin....That is, 5-FU + Avastin....

Well....I am now back to where I was last October...my CEA is past 24 and started feeling a very sharp pain in my right upper quadrant. This coming monday I have to take another CAT to see what is going on. Bottom Line: I feel the current therapy has been an unmitigated disaster for me. Oxaliplatin was working so well....I was taking it like a Champ. Zero side effects...After 10 rounds I had no signs of any peripheral neuropathy developing......Now...I am a bit depressed.

My local Oncologist has told me that he will start me on FOLFIRI + Avastin next week.....I am checking with Sloan Kettering on Monday.

My question to everyone...Have you heard of Oxaliplatin causing splenomegaly???

I am seriously considering removing the spleen....so that I can go back to doing some more FOLFOX cycles after I am done with FOLFIRI....

Does removing your spleen increases your chances of having more side effects from the Chemo or having much worst CBC readings???

[missjv]

hi,
wow thats a hard one. at least your going through sloan and they seem to know what they are talking about as far as treatments. why not try folfiri and see if the repsonse is the same without effecting the spleen? have your liver mets shrunk to maybe a size where they can be removed? how about lung nodule is it in a place that it can be surgically removed? i have read and i met a person at sloan actually who had liver and lung resection and she is doing great. i know you can live without a spleen but i don't know how it would effect the bodies immune system and you certainly need a strong immune system to fight cancer. wow i wish you luck hope everything goes well.

missjv

[skier03]

Hi there!

Well, I don't know much about an enlarged spleen from chemo, because I did not have that happen. However, I can speak a bit about fighting cancer and tolerating chemo without a spleen...

Just about one year ago, a spot was found on my spleen after a routine PET/CT. The doctors did not know what it was, cancer being highly unlikely, but we decided to remove it anyway, just in case. When the pathology came back, it turned out I had beaten the odds, and did in fact have mets to my spleen. So, I had to undergo another 6 months of chemo (this time FOLFORI & Avastin) with no spleen.

I didn't have any trouble at all tolerating chemo or with my blood counts dropping too low to receive chemo. Granted, I didn't really have any problems the first time around when I had a spleen, so I don't know if that means anything... But without a spleen I received FOLFOI & Avastin every 2 weeks for 6 months. I never missed a treatment, blood counts were always good, but I did, of course, get quite tired. I found that this treatment knocked me out much faster than FOLFOX, but it could have been the different drugs, rather than the lack of a spleen.

Also, my doctors told me that while a spleen is important, and it's always better to have your organs than not have them, you can in fact live a very long and healthy life without your spleen, even when fighting cancer. Your spleen is an important part of your immune system when you are very young and are fighting many new germs and viruses. However, the older you get, the less your spleen has to do since you have already been exposed to so many germs, etc. Your spleen does also help produce red and white blood cells, but my doctors also assured me that this would not be an issue once my spleen was removed and I was back on chemotherapy. So, basically, if you do decide to or have to have your spleen removed, it should not significantly affect your immune system or ability to fight disease.

Hope this has helped. Good luck and let me know if I can be of any more assistance!

Skier03