Rapid progression of metastatic osteosarcoma after initiation of a reduced-intensity conditioning regimen with immunosuppressive fludarabine.
Indications for RIST have not been established in patients with solid tumors. In this study, we performed RIST as immunotherapy in a 13-yr-old girl with intractable but not progressive osteosarcoma, which originated from the inter-costal region. Carcinomatous pleurisy suddenly developed after the start of a conditioning regimen that included Flu and BUS. She died of respiratory failure on day +19 without signs of engraftment. This case suggests that unexpected acceleration of tumor growth may occur following RIST with immunosuppressive drugs before the development of a beneficial GVT effect.
Shinkoda
Yuichi
Y
Section of Pediatrics, National Kyushu Cancer Center, Minami-ku, Fukuoka City, Japan. shinkoda@nk-cc.go.jp
Ijichi
Osamu
O
Tanabe
Takayuki
T
Nishikawa
Takuro
T
Manago
Kunihiro
K
Ishikawa
Shuji
S
Kodama
Yuichi
Y
Okamoto
Yasuhiro
Y
Ikarimoto
Naoaki
N
Kawano
Yoshifumi
Y
D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D002648:Child; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D019653:Myeloablative Agonists; D012516:Osteosarcoma / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary*; D010997:Pleural Neoplasms / Q000175:diagnosis / Q000556:secondary*; D013902:Radiography, Thoracic; D014740:Vidarabine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000970:Antineoplastic Agents; D019653:Myeloablative Agonists; D014740:Vidarabine; C024352:fludarabine