title: Non-myeloablative hematopoietic stem cell transplantation for the treatment of adult T-cell lymphoma in a patient with advanced hepatic impairment.
abstract: 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.
authors.affiliation: Department of Hematology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Tamae
authors.initials: T
authors.lastname: Hamaki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kami
authors.forename: Masahiro
authors.initials: M
authors.lastname: Igarashi
authors.forename: Eiji
authors.initials: E
authors.lastname: Kusumi
authors.forename: Yasuji
authors.initials: Y
authors.lastname: Arase
authors.forename: Toru
authors.initials: T
authors.lastname: Ishibashi
authors.forename: Kenji
authors.initials: K
authors.lastname: Shimamura
authors.forename: Shigesaburo
authors.initials: S
authors.lastname: Miyakoshi
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Morinaga
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Takaue
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hayashi
authors.forename: Yoshitomo
authors.initials: Y
authors.lastname: Mutou
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D003520:Cyclophosphamide; D014740:Vidarabine; C024352:fludarabine