Living-donor liver transplantation providing an adequate chemotherapy for a pediatric patient with anaplastic large cell lymphoma complicated with liver failure due to the aggravation of biliary hepatopathy by secondary hemophagocytic lymphohistiocytosis
| Autor: | Kenichi Sakamoto, Tomoo Osumi, Satoshi Yoshimura, Takao Deguchi, Kimikazu Matsumoto, Seiichi Shimizu, Motohiro Kato, Noriyuki Nakano, Daisuke Tomizawa, Takako Yoshioka, Mureo Kasahara, Osamu Miyazaki, Nobutaka Kiyokawa, Syunsuke Nosaka, Seisuke Sakamoto, Akinari Fukuda |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Secondary Hemophagocytic Lymphohistiocytosis medicine.medical_specialty medicine.medical_treatment Biliary cirrhosis Liver transplantation Gastroenterology Lymphohistiocytosis Hemophagocytic hemic and lymphatic diseases Internal medicine Living Donors medicine Humans Child Brentuximab vedotin Anaplastic large-cell lymphoma Brentuximab Vedotin Chemotherapy Hemophagocytic lymphohistiocytosis Liver Cirrhosis Biliary business.industry Hematology medicine.disease Combined Modality Therapy Liver Transplantation Consolidation Chemotherapy Treatment Outcome Disease Progression Lymphoma Large-Cell Anaplastic Liver function business Liver Failure medicine.drug |
| Zdroj: | International Journal of Hematology. 112:900-905 |
| ISSN: | 1865-3774 0925-5710 |
| Popis: | Anaplastic large cell lymphoma (ALCL) accounts for 10-15% of childhood non-Hodgkin lymphoma cases; it is generally chemo-sensitive and is one of the most curable pediatric cancers. We report here a case of pediatric ALCL complicated with acute liver failure due to the aggravation of pre-existing biliary hepatopathy by lymphoma-associated hemophagocytic lymphohistiocytosis (HLH). Although the initial treatment response against ALCL was very good, poor and irreversible liver function due to biliary cirrhosis worsening by lymphoma-associated HLH prevented the patient from receiving further consolidation chemotherapies. To make matters worse, his condition was accompanied with intrahepatic fungal pseudoaneurysm and invasive fungal infection. Thus, we decided to perform an urgent living-donor liver transplantation from his father to correct the patient's liver function and make it possible to proceed with further ALCL therapy. After the living-donor liver transplantation, the patient successfully received consolidation therapy with brentuximab vedotin. To our knowledge, this may be an early reported case of a pediatric patient undergoing liver transplantation during treatment for ALCL. In most patients with HLH-associated ALCL, liver function improves when ALCL is controlled. However, acute liver failure is occasionally observed in HLH cases with pre-existing liver dysfunction. In such cases, liver transplantation should be considered to correct liver dysfunctions if the disease control of HLH is satisfactory. |
| Databáze: | OpenAIRE |
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