A case of acute myeloblastic leukemia with hemorrhagic infarct of biliateral lungs after L-Asparaginase treatment
| Autor: | Tatsuto Tonooka, Yoshio Hatae, Katsuaki Itakura, Takeo Takeda, Tateo Ogura, Nobuko Akino |
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| Rok vydání: | 1975 |
| Předmět: | |
| Zdroj: | Blood & Vessel. 6:423-430 |
| ISSN: | 1884-2372 0386-9717 |
| DOI: | 10.2491/jjsth1970.6.423 |
| Popis: | Since the first successful treatment by Ottgen in 1967, L-Asparagi vase has become one of the most popularly used antileukemic drugs in the world. The effectiveness of the drug upon acute leukemia, especially that of childhood, and lymp-hosarcoma is widely accepted. On the other hand, however, several side effects have also been reported, which include toxicity to liver and pancreas, disturbance of bloodcoagulation and thrombosis of the brain. We reported here a case of pulmonary infarction probably due to L-Asparaginase treatment.S. N., a Japanese boy, born on April 27, 1960 was admitted to Hokkaido University Hospital on September 6, 1971 because of acute myelogenous leukemia. Onset of his disease was middle of August, 1971, when he had recurrent fever and lassitude. with the combination chemotherapy of Prednisolone, Daunomycin, Vincristine, he got complete remission and was allowed to go home on December 29, 1971. After about one month's duration of complete remission he relapsed.On his second admission to our clinic on Feb. 18, 1972. hemanalysis showed moderate anemia (RBC 290×104/mm3), slight increase of WBC (16, 000/mm3) with highpercentage of myeloblasts (72%) and decreased platelet count (110, 000mm3) In the bone marrow smears myeloblasts occupied 72% of whole nucleated cells. No splenomegaly was observed. CRP 3mm. ESR 22mm (1hr.), 52mm (2hrs.). After ineffective trials of several kinds of combination chemotherapy with Prednisolone, Daunomycin, Ara-C, Vincristine and Methotrexate, intravenous administration of L-Asparaginase (200U/Kg/day) was begun on June 1, 1972. On the third day of the treatment high fever subsided and the percentage of myeloblast in the peripheral blood smear decreased remarkably, but on the eighth day thrombophlebitis appeared on the back of the left foot. Three days late he began to complain of serious pain in the back on respiration and in the left arm. Next day he felt his left arm numb and blood pressure on the same arm revealed marked decrease. Inspite of the Urokinase therapy the patient died on July 11, 1972.Autopsy revealed hemorrhagic infarct of bilateral lungs, fatty degeneration of pancreas and liver. In the treatment with L-Asparaginase, we advise careful consideration of the side effects of this drug in relation to the condition of the patients. |
| Databáze: | OpenAIRE |
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