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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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| Published in: | Pediatric transplantation 2016-02, Vol.20 (1), p.168-171 |
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| container_end_page | 171 |
| container_issue | 1 |
| container_start_page | 168 |
| container_title | Pediatric transplantation |
| container_volume | 20 |
| creator | Hsu, Wan‐Yi Chiou, Shyh‐Shin Liao, Yu‐Mei Shu, Hsiu‐Lan Zeng, Yu‐Sheng Wong, Cheong‐Chew Lin, Pei‐Chin |
| description | 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. |
| doi_str_mv | 10.1111/petr.12644 |
| format | article |
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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.</description><identifier>ISSN: 1397-3142</identifier><identifier>EISSN: 1399-3046</identifier><identifier>DOI: 10.1111/petr.12644</identifier><identifier>PMID: 26670732</identifier><language>eng</language><publisher>Denmark</publisher><subject>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</subject><ispartof>Pediatric transplantation, 2016-02, Vol.20 (1), p.168-171</ispartof><rights>2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4324-7ebfa828f775046c93b228c7964c8ced5eb93841dcc35eb4acaf3516181616f13</citedby><cites>FETCH-LOGICAL-c4324-7ebfa828f775046c93b228c7964c8ced5eb93841dcc35eb4acaf3516181616f13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27900,27901</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26670732$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hsu, Wan‐Yi</creatorcontrib><creatorcontrib>Chiou, Shyh‐Shin</creatorcontrib><creatorcontrib>Liao, Yu‐Mei</creatorcontrib><creatorcontrib>Shu, Hsiu‐Lan</creatorcontrib><creatorcontrib>Zeng, Yu‐Sheng</creatorcontrib><creatorcontrib>Wong, Cheong‐Chew</creatorcontrib><creatorcontrib>Lin, Pei‐Chin</creatorcontrib><title>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</title><title>Pediatric transplantation</title><addtitle>Pediatr Transplant</addtitle><description>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.</description><subject>Adolescent</subject><subject>anemia</subject><subject>Autoimmune Diseases - therapy</subject><subject>autologous PBSCT</subject><subject>Azathioprine - administration & dosage</subject><subject>Bone Marrow Transplantation</subject><subject>Cell Lineage</subject><subject>Cyclophosphamide - administration & dosage</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>Hodgkin Disease - complications</subject><subject>Hodgkin Disease - therapy</subject><subject>Hodgkin's disease</subject><subject>Humans</subject><subject>Male</subject><subject>neutropenia</subject><subject>Pancytopenia - therapy</subject><subject>rituximab</subject><subject>Rituximab - therapeutic use</subject><subject>Sepsis - physiopathology</subject><subject>thrombocytopenia</subject><subject>Thrombocytopenia - therapy</subject><subject>Transplantation, Autologous</subject><subject>Treatment Outcome</subject><subject>Venous Thrombosis - complications</subject><subject>Venous Thrombosis - therapy</subject><issn>1397-3142</issn><issn>1399-3046</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNqNkctu1TAQhiMEoqWw4QHQLBFSSnyJ4yxR1QtSJRCUdeQ4k3MMvoTYaXV2PEKfjUfgSXDOKSwRliyPxp__f-S_KF6S6pTk9XbCNJ8SKjh_VBwT1rYlq7h4vK-bkhFOj4pnMX6tKiK45E-LIypEUzWMHhc_Py9aY4zjYsEprzbo0CcII7jFJmONx9wDtaRgnFs8gt6lMKE3CnRwkzVaJRzgzqQtRLzFGcH4EXUywYPyAwyIE9yi8ZC2c3B9iCZmBBRMKpnVbP_2Kgybb7ltd27aBpdvQ0y_ftyvzjZswhJhi05l72AwGQ0xoQON1kKalY-TVT6p1fV58WRUNuKLh_Ok-HJxfnN2VV5_uHx_9u661JxRXjbYj0pSOTZNnb9Lt6ynVOqmFVxLjUONfcskJ4PWLNdcaTWymggi8xYjYSfF64PuNIfvC8bUORPXgZTHPG5HGllTRkVD_wMVshaslSKjbw6onkOMM47dNBun5l1Hqm6Nu1vj7vZxZ_jVg-7SOxz-on_yzQA5AHfG4u4fUt3H85tPB9HfLKq9zg</recordid><startdate>201602</startdate><enddate>201602</enddate><creator>Hsu, Wan‐Yi</creator><creator>Chiou, Shyh‐Shin</creator><creator>Liao, Yu‐Mei</creator><creator>Shu, Hsiu‐Lan</creator><creator>Zeng, Yu‐Sheng</creator><creator>Wong, Cheong‐Chew</creator><creator>Lin, Pei‐Chin</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>201602</creationdate><title>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</title><author>Hsu, Wan‐Yi ; Chiou, Shyh‐Shin ; Liao, Yu‐Mei ; Shu, Hsiu‐Lan ; Zeng, Yu‐Sheng ; Wong, Cheong‐Chew ; Lin, Pei‐Chin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4324-7ebfa828f775046c93b228c7964c8ced5eb93841dcc35eb4acaf3516181616f13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>anemia</topic><topic>Autoimmune Diseases - therapy</topic><topic>autologous PBSCT</topic><topic>Azathioprine - administration & dosage</topic><topic>Bone Marrow Transplantation</topic><topic>Cell Lineage</topic><topic>Cyclophosphamide - administration & dosage</topic><topic>Hematopoietic Stem Cell Transplantation</topic><topic>Hodgkin Disease - complications</topic><topic>Hodgkin Disease - therapy</topic><topic>Hodgkin's disease</topic><topic>Humans</topic><topic>Male</topic><topic>neutropenia</topic><topic>Pancytopenia - therapy</topic><topic>rituximab</topic><topic>Rituximab - therapeutic use</topic><topic>Sepsis - physiopathology</topic><topic>thrombocytopenia</topic><topic>Thrombocytopenia - therapy</topic><topic>Transplantation, Autologous</topic><topic>Treatment Outcome</topic><topic>Venous Thrombosis - complications</topic><topic>Venous Thrombosis - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hsu, Wan‐Yi</creatorcontrib><creatorcontrib>Chiou, Shyh‐Shin</creatorcontrib><creatorcontrib>Liao, Yu‐Mei</creatorcontrib><creatorcontrib>Shu, Hsiu‐Lan</creatorcontrib><creatorcontrib>Zeng, Yu‐Sheng</creatorcontrib><creatorcontrib>Wong, Cheong‐Chew</creatorcontrib><creatorcontrib>Lin, Pei‐Chin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Pediatric transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hsu, Wan‐Yi</au><au>Chiou, Shyh‐Shin</au><au>Liao, Yu‐Mei</au><au>Shu, Hsiu‐Lan</au><au>Zeng, Yu‐Sheng</au><au>Wong, Cheong‐Chew</au><au>Lin, Pei‐Chin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>Pediatric transplantation</jtitle><addtitle>Pediatr Transplant</addtitle><date>2016-02</date><risdate>2016</risdate><volume>20</volume><issue>1</issue><spage>168</spage><epage>171</epage><pages>168-171</pages><issn>1397-3142</issn><eissn>1399-3046</eissn><abstract>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.</abstract><cop>Denmark</cop><pmid>26670732</pmid><doi>10.1111/petr.12644</doi><tpages>4</tpages></addata></record> |
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| ispartof | Pediatric transplantation, 2016-02, Vol.20 (1), p.168-171 |
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| language | eng |
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| source | Wiley-Blackwell Read & Publish Collection |
| 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 |
| title | 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 |
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