Successful management of bleeding with recombinant factor VIIa (NovoSeven) in a patient with Burkitt lymphoma and thrombosis of the left femoral and left common iliac veins.
We present the case of an 18-year-old female with Burkitt lymphoma involving the intra-abdominal and inguinal lymph nodes. The tumor had invaded the left femoral and common iliac veins causing secondary thrombosis and vessel occlusion. Chemotherapy and anticoagulant treatment resulted in mild thrombocytopenia and a prolonged prothrombin time, respectively, which exacerbated postoperative bleeding following surgical removal of a deep inguinal necrosis. After 6 days, bleeding combined with epistaxis was considered to be life threatening and anticoagulant reversal with recombinant factor VIIa was successfully performed. The patient has since achieved complete remission and subsequent antithrombotic therapy has resolved the vascular occlusion.
Culić
Srdana
S
Department of Hematology, Oncology, Immunology and Medical Genetics, Pediatric Clinic, Clinical Hospital Split, Split, Spincićeva 1, Croatia. srdjana.culic@st.htnet.hr
Kuljis
Dubravka
D
Armanda
Visnja
V
Jankovic
Stipan
S
D000293:Adolescent; D000925:Anticoagulants / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects; D002051:Burkitt Lymphoma / Q000150:complications / Q000188:drug therapy; D015942:Factor VIIa / Q000627:therapeutic use*; D005260:Female; D005268:Femoral Vein; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects; D006801:Humans; D007084:Iliac Vein; D019106:Postoperative Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D011994:Recombinant Proteins / Q000627:therapeutic use; D013921:Thrombocytopenia / Q000139:chemically induced / Q000150:complications; D020246:Venous Thrombosis / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*
D000925:Anticoagulants; D000970:Antineoplastic Agents; D006495:Heparin, Low-Molecular-Weight; D011994:Recombinant Proteins; D015942:Factor VIIa