Irreversible marrow aplasia after single course of 2-chlorodeoxyadenosine for hairy cell leukaemia preceding by A pandemic 2009-H1N1-associated pneumonia.
Hairy cell leukaemia (HCL) is a rare, indolent lymphoproliferative disorder characterized by varying degrees of cytopenias and the presence of malignant B cells with cytoplasmic projections. Cladribine (2-chlorodeoxyadenosine, 2-CdA) is an adenosine deaminase-resistant purine analogue and has been shown to be very effective as a first-line therapeutic option for HCL. The therapy with 2-CdA is found to be well tolerated with a paucity of toxicity. The common side effects include immunosuppression and reversible myelosuppression. We report a HCL patient with A pandemic 2009-H1N1-associated pneumonia who fully recovered after oseltamivir and antibiotics. The subsequent treatment with single 5-day course of 2-CdA resulted in persistent marrow aplasia with fatal systemic aspergillosis.
Helbig
Grzegorz
G
Department of Haematology and Bone Marrow Transplantation, Silesian Medical University, Dabrowski Street 25, 40-032, Katowice, Poland. ghelbig@o2.pl
Woźniczka
Krzysztof
K
Wieczorkiewicz
Agata
A
Pająk
Jacek
J
Kyrcz-Krzemien
Sławomira
S
D000658:Amoxicillin / Q000627:therapeutic use; D000741:Anemia, Aplastic / Q000139:chemically induced* / Q000473:pathology; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000998:Antiviral Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000150:complications; D001853:Bone Marrow / Q000187:drug effects / Q000473:pathology; D002939:Ciprofloxacin / Q000627:therapeutic use; D017338:Cladribine / Q000009:adverse effects*; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D007943:Leukemia, Hairy Cell / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D053139:Oseltamivir / Q000627:therapeutic use; D010198:Pancytopenia / Q000209:etiology; D058873:Pandemics; D011024:Pneumonia, Viral / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D055815:Young Adult
D000890:Anti-Infective Agents; D000970:Antineoplastic Agents; D000998:Antiviral Agents; D053139:Oseltamivir; D017338:Cladribine; D002939:Ciprofloxacin; D000658:Amoxicillin