{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T06:37:44Z","timestamp":1763707064893,"version":"build-2065373602"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>A 10-year-old female with osteoblastic osteosarcoma developed life-threatening cisplatin-induced myelosuppression (grade IV neutropenia\/thrombocytopenia) following the eighth cycle of MAP chemotherapy. Critical pharmacological findings include a cumulative cisplatin dose of 720\u00a0mg\/m<jats:sup>2<\/jats:sup>exceeding the pediatric safety threshold of 400\u00a0mg\/m<jats:sup>2<\/jats:sup>. The CYP3A5*1\/*1 genotype prolonged the half-life of cisplatin to 8.2\u00a0h. Cisplatin-specific biomarkers included serum magnesium 1.2\u00a0mg\/dL and urinary N-acetyl-\u03b2-D-glucosaminidase 48 U\/L. Targeted interventions (G-CSF, romiplostim, meropenem) led to hematological recovery within 14\u00a0days. This case implicates cisplatin overdose with impaired metabolic clearance as the primary toxicity mechanism.<\/jats:p>","DOI":"10.3389\/fphar.2025.1668180","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T05:32:29Z","timestamp":1759210349000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Life-threatening cisplatin-induced myelosuppression in pediatric osteosarcoma: molecular mechanisms, pharmacogenomic profiling, and targeted clinical management"],"prefix":"10.3389","volume":"16","author":[{"given":"Chuanqiang","family":"Dai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youshu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Dong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"B1","first-page":"817","article-title":"Methotrexate, doxorubicin, and cisplatin (MAP) plus maintenance pegylated interferon alfa-2b versus MAP alone in patients with resectable high-grade osteosarcoma and good histologic response to preoperative MAP: first results of the EURAMOS-1 good response randomized controlled trial","volume":"40","author":"Bielack","year":"2022","journal-title":"J. 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