Fatal deep vein thrombosis after allogeneic reduced intensity hematopoietic stem cell transplantation for the treatment of metastatic gastric cancer.
A 61-year-old man received reduced intensity stem cell transplantation (RIST) for the treatment of metastatic gastric cancer. The cytoreductive course of RIST was uneventful until day 0, when fever suddenly developed and his performance status deteriorated. Edema developed in the bilateral lower extremities by day 7, which was diagnosed by Doppler ultrasonography as deep vein thrombosis (DVT) involving the femoral veins to the inferior vena cava. While the edema improved with anticoagulation treatment, gastrointestinal graft-versus-host disease (GVHD) followed on day 13. Diarrhea subsided spontaneously, but hypoalbuminemia persisted, with the subsequent development of oliguria and jaundice on day 18. He died of sepsis on day 30, without any evidence of cancer progression. This case demonstrates that DVT is a potentially significant problem following RIST for solid tumors.
Kamitsuji
Yuri
Y
Hematopoietic Stem Cell Transplantation Unit, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
Mori
Shin-Ichiro
S
Kami
Masahiro
M
Yamada
Hirofumi
H
Shirakawa
Kazuo
K
Kishi
Yukiko
Y
Murashige
Naoko
N
Kim
Sung-Won
SW
Heike
Yuji
Y
Takaue
Yoichi
Y
D000925:Anticoagulants / Q000627:therapeutic use; D017809:Fatal Outcome; D005268:Femoral Vein; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D018805:Sepsis / Q000209:etiology; D013274:Stomach Neoplasms / Q000150:complications* / Q000473:pathology / Q000628:therapy*; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods; D014184:Transplantation, Homologous; D020246:Venous Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*
D000925:Anticoagulants