Successful cord blood transplantation in an adult acute lymphoblastic leukemia patient with congenital heart disease.
Recent advances in surgical corrections and supportive care for congenital heart disease have resulted in increasing numbers of adult survivors who may develop hematological malignancies. Treatments including chemotherapy for such patients may cause serious hemodynamic or cardiac complications, especially in those receiving stem cell transplantation. We present a 29-year-old woman with acute lymphoblastic leukemia and congenital heart disease. She had been diagnosed with pulmonary atresia with an intact ventricular septum at birth, and the anomaly was surgically corrected according to the Fontan technique at age 9 years. Her induction chemotherapy required modifications due to poor cardiac status with Fontan circulation. However, after surgical procedures including total cavopulmonary connection and aortic valve replacement at first complete remission, her cardiac status was significantly improved. Subsequently, she underwent cord blood stem cell transplantation at the third complete remission. She required intensive supportive care for circulatory failure as a pre-engraftment immune reaction and stage III acute graft versus host disease of the gut, but recovered from these complications. She was discharged on day 239, and remained in complete remission at 1-year post-transplantation.
Hematology and Oncology, Internal medicine, Iwate Medical University.
Shugo
S
Kowata
Yukiteru
Y
Fujishima
Yuzo
Y
Suzuki
Yasuhiko
Y
Tsukushi
Tatsuo
T
Oyake
Ryou
R
Togawa
Kotaro
K
Oyama
Akio
A
Ikai
Shigeki
S
Ito
Yoji
Y
Ishida
D000328:Adult; D036101:Cord Blood Stem Cell Transplantation; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications*; D006801:Humans; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome