title: [Multiple organ failure presumably due to alkylating agents used as preconditioning drugs for autologous peripheral blood stem cell transplantation in an acute promyelocytic leukemia].
abstract: A 52-year-old male was diagnosed as having acute promyelocytic leukemia (APL) in 2006. He received induction chemotherapy including all-trans retinoic acid and initially achieved a complete remission (CR). After several courses of consolidation therapy combining anthracyclines and cytarabine, he maintained CR. In 2009, an APL relapse was diagnosed, and he was treated with arsenic trioxide. Since he achieved a second CR, he underwent autologous peripheral blood stem cell transplantation (auto-PBSCT) with a conditioning regimen consisting of busulfan and melphalan. At four months after auto-PBSCT, he developed a pneumothorax and acute respiratory failure. He died despite intensive therapy. Autopsy findings included various atypical and apoptotic cells in his pulmonary tissue. These changes were confirmed in multiple organs throughout the body, suggesting them to be drug-induced. The findings in this case suggested multiple organ failure due to alkylating agents.
authors: Department of Hematology, Nagaoka Red Cross Hospital.
authors: Tori
authors: T
authors: Ida
authors: Shigeo
authors: S
authors: Hashimoto
authors: Nobuaki
authors: N
authors: Suzuki
authors: Yusuke
authors: Y
authors: Ebe
authors: Toshio
authors: T
authors: Yano
authors: Naoko
authors: N
authors: Sato
authors: Tadashi
authors: T
authors: Koike
mesh_terms: D000477:Alkylating Agents / Q000009:adverse effects*; D001344:Autopsy; D017809:Fatal Outcome; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000139:chemically induced*; D036102:Peripheral Blood Stem Cell Transplantation; D019172:Transplantation Conditioning / Q000009:adverse effects*; D014182:Transplantation, Autologous
chemical_list: D000477:Alkylating Agents