Abstract

In breast cancer, complete bone marrow infiltration accompanied by severe pancytopenia is extremely uncommon. After metastatic breast cancer develops, bone marrow metastasis may frequently occur. However, it is uncommon to observe bone marrow failure as a sign of this disease. The safest and most effective way to treat patients with severe pancytopenia caused by metastatic solid tumor involvement is poorly studied. The patient’s thrombocytopenia was particularly concerning in this instance, necessitating daily platelet transfusions. Cytotoxic chemotherapy was also feared to worsen the patient’s thrombocytopenia and increase the risk of bleeding. The patient’s remarkable response to chemotherapy, which resulted in a complete recovery of her platelets, is also extremely unusual. Even though our patient had a low baseline platelet level, continuous doxorubicin was able to successfully “unpack” the bone marrow without increasing the need for more frequent platelet transfusions or the risk of catastrophic bleeding. Due to the rarity of this presentation, it is currently unknown if the majority of comparable patients experience near-full recovery of hematopoietic function upon beginning the appropriate systemic treatment for metastatic disease.