Successful management of multilineage autoimmune cytopenia complicated with severe infection and deep vein thrombosis in a patient with Hodgkin lymphoma post‐autologous hematopoietic stem cell transplantation

Autoimmune cytopenia (AIHA, AITP or AIN) were uncommon paraneoplastic manifestations of HL and have been recognized in patients after HSCT with dismal outcome. We presented a case of 16‐yr‐old male with Hodgkin's lymphoma who developed severe AIC involving all three cell lineages after autologu...

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Bibliographic Details
Published in:Pediatric transplantation 2016-02, Vol.20 (1), p.168-171
Main Authors: Hsu, Wan‐Yi, Chiou, Shyh‐Shin, Liao, Yu‐Mei, Shu, Hsiu‐Lan, Zeng, Yu‐Sheng, Wong, Cheong‐Chew, Lin, Pei‐Chin
Format: Article
Language:English
Subjects:
Adolescent
anemia
Autoimmune Diseases - therapy
autologous PBSCT
Azathioprine - administration & dosage
Bone Marrow Transplantation
Cell Lineage
Cyclophosphamide - administration & dosage
Hematopoietic Stem Cell Transplantation
Hodgkin Disease - complications
Hodgkin Disease - therapy
Hodgkin's disease
Humans
Male
neutropenia
Pancytopenia - therapy
rituximab
Rituximab - therapeutic use
Sepsis - physiopathology
thrombocytopenia
Thrombocytopenia - therapy
Transplantation, Autologous
Treatment Outcome
Venous Thrombosis - complications
Venous Thrombosis - therapy
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Summary:Autoimmune cytopenia (AIHA, AITP or AIN) were uncommon paraneoplastic manifestations of HL and have been recognized in patients after HSCT with dismal outcome. We presented a case of 16‐yr‐old male with Hodgkin's lymphoma who developed severe AIC involving all three cell lineages after autologus bone marrow transplantation. No disease relapse was noted. Treatments with steroid, IVIG and immunosuppresants were in vain and the disease course was complicated with sepsis and deep vein thrombosis. Rituximab was administered along with broad‐spectrum antibiotics and low‐molecular weight heparin. The condition became stable and pancytopenia recovered after four doses of rituximab treatment. Severe multi‐lineage AIC post HSCT is usually refractory to first‐line treatment and difficult to manage. Second‐line treatment, such as rituximab, and dedicated care for pancytopenia‐induced or treatment‐related complications may provide a better outcome.
ISSN:1397-3142
1399-3046
DOI:10.1111/petr.12644