Thrombotic microangiopathy of hyperacute onset after autologous peripheral blood stem cell transplantation in malignant lymphoma.
Bone marrow transplant-associated thrombotic microangiopathy (BMT-TM), usually associated with thrombocytopenia, microangiopathic haemolytic anaemia (MAHA) and renal insufficiency, has been reported to occur approximately 5-6 months after BMT. We report a case of relapsed malignant lymphoma complicated by BMT-TM of hyperacute onset, which has never been described in the literature. Our patient, a 52-year-old male, developed MAHA with gross haematuria, thrombocytopenia, lactate dehydrogenase elevation and renal insufficiency 2 days after autologous PBSC transplantation following high-dose chemotherapy. Supportive treatment, ie glucocorticoid, fresh frozen plasma and haemodiafiltration were given, and thereafter the BMT-TM gradually improved. In heavily pretreated patients, caution should be exercised for possible occurrence of the BMT-TM of hyperacute onset.
Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
K
K
Togitani
K
K
Takeyama
T
T
Yokozawa
M
M
Andoh
M
M
Narabayashi
Y
Y
Kobayashi
T
T
Takenaka
K
K
Tobinai
D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D016399:Lymphoma, T-Cell / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D013927:Thrombosis / Q000209:etiology*; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous