Clinical characteristics, treatment, and outcomes of Oxaliplatin-induced immune thrombocytopenia

BackgroundAlthough myelosuppression is its common dose-limiting toxicity, oxaliplatin-induced immune thrombocytopenia (OITP), a rare and potentially fatal type II hypersensitivity reaction, is often misdiagnosed as ordinary myelosuppression due to insufficient clinical awareness.MethodsRelevant literature published up to December 31, 2025 were retrieved from databases including PubMed, Scopus, Embase, Web of Science, Cochrane Library, Wanfang Medical Database and China National Knowledge Infrastructure (CNKI). Cases confirmed as OITP were strictly screened for retrospective analysis.ResultsAmong the 40 included patients, the median age was 59 years (range, 36–83 years), with a significant female predominance (65.0%).

The main primary disease was colorectal cancer (92.5%), and the most commonly used chemotherapy regimen was FOLFOX (77.5%). OITP onset was characterized by a distinct latent period, with a median time to onset of the 9th chemotherapy cycle (range, 2–28 cycles).

The clinical manifestations were severe: 82.5% of patients had a platelet count drop to < 25×109/L, with a median nadir of only 6×109/L. Bleeding symptoms were evident in 65.0% of patients, and 52.5% of patients had accompanying systemic hypersensitivity symptoms such as fever and chills.