RESUMEN
OBJECTIVES: The objective of this study is to evaluate the toxicity of autologous transplantation of non-frozen peripheral blood stem cells in Moroccan patients with multiple myeloma. MATERIAL AND METHODS: This was a bicentric retrospective study conducted in the Clinical Haematology Department of Mohammed V Military Teaching Hospital and at the Al Madina Clinic in Casablanca. The study period was from January 2015 to June 2019. All patients with multiple myeloma who had undergone an autologous peripheral stem cell transplant without freezing were included. Mobilisation was performed with lenograstim alone and the collected stem cells were stored for 24-48hours in a blood bank refrigerator at a temperature of 4°C. After standard conditioning with high-dose melphalan, the peripheral blood stem cells were reinjected 24 h following conditioning. RESULTS: Over the study period, 55 patients received an autologous transplant using non-frozen peripheral blood stem cells. The median richness of the CD34 cells collected was 4.5×106 CD34/kg (range: 2-12.2). The time required for neutrophil recovery was 12 days (range: 7-19). The time required for platelet recovery was 14 days (range: 9-32). The mortality rate within 100 days post-transplant was 3.6%. We did not observe any cases of graft failure. CONCLUSION: Our study finds good feasibility and low toxicity of autologous peripheral stem cell transplantation without freezing in patients with multiple myeloma.
Asunto(s)
Conservación de la Sangre , Mieloma Múltiple/terapia , Trasplante de Células Madre de Sangre Periférica/métodos , Adulto , Anciano , Recuento de Células Sanguíneas , Conservación de la Sangre/métodos , Femenino , Supervivencia de Injerto , Movilización de Célula Madre Hematopoyética , Humanos , Lenograstim/farmacología , Masculino , Melfalán/farmacología , Persona de Mediana Edad , Marruecos , Mieloma Múltiple/sangre , Trasplante de Células Madre de Sangre Periférica/efectos adversos , Estudios Retrospectivos , Acondicionamiento Pretrasplante/efectos adversos , Trasplante AutólogoRESUMEN
Thrombosis and hemorrhage are two opposing manifestations of multiple myeloma. These hemostatic disorders are present in less than 12% of patients at diagnosis and involve various pathophysiological mechanisms. We report the case of a 39-year-old patient with multiple myeloma revealed by the association of a hemorrhagic syndrome and deep vein thrombosis related to a hypoprothrombinemia-anticoagulant lupus syndrome.
Asunto(s)
Mieloma Múltiple/diagnóstico , Adulto , Hemorragia/etiología , Humanos , Hipoprotrombinemias/etiología , Cadenas Ligeras de Inmunoglobulina , Inhibidor de Coagulación del Lupus , Masculino , Mieloma Múltiple/complicaciones , Síndrome , Trombosis/etiologíaAsunto(s)
Antibióticos Antineoplásicos/efectos adversos , Bleomicina/efectos adversos , Enfermedades Pulmonares Intersticiales/inducido químicamente , Enfisema Mediastínico/inducido químicamente , Neumotórax/inducido químicamente , Antibióticos Antineoplásicos/uso terapéutico , Bleomicina/uso terapéutico , Resultado Fatal , Enfermedad de Hodgkin/tratamiento farmacológico , Humanos , Pulmón/patología , Enfermedades Pulmonares Intersticiales/complicaciones , Masculino , Enfisema Mediastínico/complicaciones , Persona de Mediana Edad , Neumotórax/complicaciones , Tomografía Computarizada por Rayos XRESUMEN
A 32-year-old male presented with advanced renal failure and nephrotic proteinuria due to lambda light chain multiple myeloma. Renal biopsy showed a proliferative glomerulonephritis with isolated C3 deposits. Renal recovery was obtained after chemotherapy and autologous stem cell transplant. We review previously described cases of C3 glomerulopathy associated with monoclonal gammopathy.
Asunto(s)
Dolor Agudo/etiología , Transfusión de Plaquetas/efectos adversos , Reacción a la Transfusión/etiología , Anemia Aplásica/terapia , Trasplante de Médula Ósea , Disnea/etiología , Humanos , Hipotensión/etiología , Masculino , Persona de Mediana Edad , Plaquetoferesis/instrumentación , Taquicardia/etiología , Trombocitopenia/etiología , Trombocitopenia/terapiaAsunto(s)
Candidiasis Invasiva/diagnóstico por imagen , Radioisótopos de Flúor , Fluorodesoxiglucosa F18 , Hepatitis/diagnóstico por imagen , Imagen Multimodal , Tomografía de Emisión de Positrones , Radiofármacos , Enfermedades del Bazo/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Anfotericina B/uso terapéutico , Antifúngicos/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Candidiasis Invasiva/tratamiento farmacológico , Candidiasis Invasiva/etiología , Neutropenia Febril Inducida por Quimioterapia/complicaciones , Citarabina/administración & dosificación , Citarabina/efectos adversos , Daunorrubicina/administración & dosificación , Daunorrubicina/efectos adversos , Hepatitis/tratamiento farmacológico , Hepatitis/etiología , Humanos , Huésped Inmunocomprometido , Leucemia Mieloide Aguda/complicaciones , Leucemia Mieloide Aguda/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Enfermedades del Bazo/tratamiento farmacológico , Enfermedades del Bazo/etiologíaRESUMEN
Introduction. We report the case of a Bing and Neel syndrome revealed by an isolated left ptosis. Case Report. a 57-year-old man was followed up since October 2003 for a typical Waldenström's macroglobulinemia. A first complete remission was obtained with chlorambucil. In August 2004, he relapsed. A second complete remission was obtained with RFC chemotherapy regimen (rituximab, fludarabine, and cyclophosphamide). In October 2009, the patient presented with an isolated left ptosis revealing a Bing and Neel syndrome. The diagnosis was suspected on MRI and confirmed by the detection in the CSF of a monoclonal IgM similar to the one found in the plasma. A quite good partial remission has been obtained after one course of RDHAP (rituximab, dexamethasone, cytarabine, and cisplatin) and 3 courses of RDHOx (rituximab, dexamethasone, cytarabine, and oxaliplatin), in addition to ten intrahectal chemotherapy injections. The treatment was followed by intensification and autologous stem cell transplantation. At D58, the patient died due to a septic shock. Conclusion. BNS is a rare and potentially treatable complication of WM. It should be considered in patients with neurologic symptoms and a history of WM.