title: Fatal pulmonary thromboembolism after a second course of high-dose chemotherapy with autologous peripheral blood stem cell transplantation.
abstract: We describe a 4-yr-old boy with an occult primitive neuroectodermal tumor, who suffered fatal PTE after a second course of HDC with autologous PBSCT. On day + 52 after a second PBSCT, he was admitted because of respiratory distress. Respiratory failure rapidly progressed and he died within 4 days. The diagnosis of PTE was confirmed by a lung perfusion study with technetium-99m macroaggregated albumin, but too late to allow treatment. Although rare, PTE must be recognized as an important differential diagnosis when respiratory symptoms are observed after HDC with PBSCT.
authors.affiliation: Department of Pediatrics, Wakayama Medical University, Kimiidera, Wakayama City, Japan. nami@mail.wakayama-med.ac.jp
authors.forename: Shinji
authors.initials: S
authors.lastname: Kounami
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Aoyagi
authors.forename: Keiko
authors.initials: K
authors.lastname: Nakayama
authors.forename: Megumi
authors.initials: M
authors.lastname: Yoshiyama
authors.forename: H
authors.initials: H
authors.lastname: Boshi
authors.forename: Michiyo
authors.initials: M
authors.lastname: Sakiyama
authors.forename: Takeshi
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Norishige
authors.initials: N
authors.lastname: Yoshikawa
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000150:complications / Q000601:surgery*; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use; D005047:Etoposide / Q000008:administration & dosage / Q000627:therapeutic use; D017809:Fatal Outcome; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D018242:Neuroectodermal Tumors, Primitive / Q000150:complications / Q000601:surgery*; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D011655:Pulmonary Embolism / Q000209:etiology* / Q000401:mortality; D014182:Transplantation, Autologous / Q000009:adverse effects; D014750:Vincristine / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D014750:Vincristine; D005047:Etoposide; D003520:Cyclophosphamide; D002945:Cisplatin; D007069:Ifosfamide