Non-myeloablative hematopoietic stem cell transplantation for the treatment of adult T-cell lymphoma in a patient with advanced hepatic impairment.
A 59-year-old man with liver cirrhosis due to hepatitis B virus infection received non-myeloablative stem-cell transplantation (NST) for the treatment of adult T-cell lymphoma. The preparative regimen consisted of cyclophosphamide and fludarabine. While the pharmacokinetics of these drugs was altered in this patient, his clinical course was uneventful without the development of severe hepatic damage. Complete remission was achieved on day 56. Although he finally died of hemorrhage from esophageal varices on day 68, this case suggests that ATL may be a good candidate for allogeneic HSCT, and that NST may be feasible for patients with hepatic impairment.
Hamaki
Tamae
T
Department of Hematology, Toranomon Hospital, Tokyo, Japan.
Kami
Masahiro
M
Igarashi
Masahiro
M
Kusumi
Eiji
E
Arase
Yasuji
Y
Ishibashi
Toru
T
Shimamura
Kenji
K
Miyakoshi
Shigesaburo
S
Morinaga
Shin-Ichi
S
Takaue
Yoichi
Y
Hayashi
Masahiro
M
Mutou
Yoshitomo
Y
D000970:Antineoplastic Agents / Q000493:pharmacokinetics; D018906:Antineoplastic Agents, Alkylating / Q000493:pharmacokinetics; D003520:Cyclophosphamide / Q000493:pharmacokinetics; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006509:Hepatitis B / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology*; D016399:Lymphoma, T-Cell / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014740:Vidarabine / Q000031:analogs & derivatives* / Q000493:pharmacokinetics
D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D003520:Cyclophosphamide; D014740:Vidarabine; C024352:fludarabine