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Cold agglutinin syndrome in a patient with metastatic breast cancer: a Case report

datacite.subject.sdg03:Saúde de Qualidade
datacite.subject.sdg09:Indústria, Inovação e Infraestruturas
datacite.subject.sdg10:Reduzir as Desigualdades
dc.contributor.authorBandarra, Daniel
dc.contributor.authorRochate, Dina
dc.contributor.authorGosalbez, Beatriz
dc.contributor.authorFerreira, José
dc.contributor.authorCunha, Nidia Maltez
dc.contributor.authorCarvalhal, Sara
dc.date.accessioned2026-02-23T13:08:33Z
dc.date.available2026-02-23T13:08:33Z
dc.date.issued2026-01-16
dc.description.abstractBackground: Cold agglutinin syndrome (CAS) is a form of autoimmune hemolytic anemia (AIHA), most often associated with lymphoproliferative disorders or infections. Its occurrence in breast cancer is rare and may be triggered by systemic treatment. Case presentation: We report the case of a woman in their fifties diagnosed with breast cancer in 2019. She underwent surgery followed by adjuvant chemotherapy and radiotherapy and subsequently received 3 years of endocrine therapy before developing bone and hepatic metastases. First-line treatment with ribociclib plus letrozole achieved partial response, and fulvestrant was administered at progression. Following further progression, paclitaxel was introduced as third-line metastatic therapy. After four weekly administrations, the patient was admitted to our hospital with severe anemia and diagnosed with CAS. Prompt management and a multidisciplinary approach resulted in partial hematological recovery. Nevertheless, paclitaxel was permanently discontinued, and subsequent therapies provided only transient benefit. The disease continued to progress, her performance status declined, and she ultimately transitioned to exclusive palliative care until death. Conclusion: This case illustrates a rare and severe immune complication of paclitaxel in metastatic breast cancer. The emergence of CAS not only limited systemic options but also reshaped the therapeutic trajectory, highlighting the need for close monitoring during cancer treatments. Early recognition, multidisciplinary approach, and prompt management can provide some improvement, although overall prognosis remains determined by the underlying malignancy.eng
dc.description.sponsorshipCEECIND/03721/2018/CP1540/CT0003
dc.identifier.doi10.3389/fmed.2025.1711809
dc.identifier.issn2296-858X
dc.identifier.urihttp://hdl.handle.net/10400.1/28219
dc.language.isoeng
dc.peerreviewedyes
dc.publisherFrontiers Media SA
dc.relation.ispartofFrontiers in Medicine
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectBreast cancer
dc.subjectChemotherapy
dc.subjectCold agglutinin syndrome (CAS)
dc.subjectAutoimmune hemolytic anemia (AIHA)
dc.subjectDrug-induced hemolysis
dc.titleCold agglutinin syndrome in a patient with metastatic breast cancer: a Case reporteng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleFrontiers in Medicine
oaire.citation.volume12
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameCarvalhal
person.givenNameSara
person.identifier.ciencia-idC511-8A34-30BE
person.identifier.orcid0000-0002-6004-3286
person.identifier.scopus-author-id56888576000
relation.isAuthorOfPublication5b4befe5-cdb3-408a-839e-8c5adc64a162
relation.isAuthorOfPublication.latestForDiscovery5b4befe5-cdb3-408a-839e-8c5adc64a162

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