RESUMEN
A 54-year-old woman visited our hospital with the chief complaints of generalized pain and thirst. Through hematologic and bone marrow examination, we diagnosed her illness as primary plasma cell leukemia. Three courses of VAD (vincristine, adriamycin and dexamethasone)therapy induced complete remission. Afterward, the patient received high-dose cyclophosphamide (4 g/m(2))for hematopoietic stem cell mobilization, and peripheral blood hematopoietic stem cells were collected 14 days later from the start of chemotherapy. Thereafter, the patient received 2 courses of high-dose melphalan (200 mg/m(2)), followed by tandem autologous peripheral blood stem cell transplantation. The patient developed no adverse events other than fever and stomatitis during the 2 transplantation courses. Fifty-six months after the transplantations, she remains in complete remission with continuous oral administration of bisphosphonate alone. Taken together, although primary plasma cell leukemia is a rare hematologic malignancy with poor prognosis, the intensive chemotherapy followed by tandem autologous peripheral blood stem cell transplantation may well improve the clinical outcome.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Leucemia de Células Plasmáticas/tratamiento farmacológico , Leucemia de Células Plasmáticas/cirugía , Trasplante de Células Madre de Sangre Periférica , Terapia Combinada , Doxorrubicina/uso terapéutico , Etopósido/uso terapéutico , Femenino , Humanos , Cadenas Pesadas de Inmunoglobulina/inmunología , Leucemia de Células Plasmáticas/inmunología , Leucemia de Células Plasmáticas/patología , Persona de Mediana Edad , Inducción de Remisión , Factores de Tiempo , Trasplante Autólogo/inmunologíaRESUMEN
Paroxysmal nocturnal hemoglobinuria is a rare acquired autoimmune disease, and is frequently associated with venous thrombosis. A patient who developed thrombotic occlusion of the inferior vena cava is described. Treatment with heparin and urokinase, followed by oral anticoagulant, was effective in resolving abdominal symptoms. The venous thrombosis resolved completely, but the patient died during treatment of aplastic anemia.