Fatal pulmonary thromboembolism after a second course of high-dose chemotherapy with autologous peripheral blood stem cell transplantation.
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.
Kounami
Shinji
S
Department of Pediatrics, Wakayama Medical University, Kimiidera, Wakayama City, Japan. nami@mail.wakayama-med.ac.jp
Aoyagi
Noriyuki
N
Nakayama
Keiko
K
Yoshiyama
Megumi
M
Boshi
H
H
Sakiyama
Michiyo
M
Takeuchi
Takeshi
T
Yoshikawa
Norishige
N
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
D014750:Vincristine; D005047:Etoposide; D003520:Cyclophosphamide; D002945:Cisplatin; D007069:Ifosfamide