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KMID : 0387820140210020140
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Clinical Pediatric Hematology-Oncology
2014 Volume.21 No. 2 p.140 ~ p.144
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A Case of Thrombotic Microangiopathy Following Autologous Stem Cell Transplantation
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Choi Jung-Yoon
Lee Ji-Won
Ju Hee-Young
Hong Che-Ry
Kim Hye-Ri
Lee Dong-Soon
Kim Nam-Hee
Kang Hyoung-Jin
Park Kyung-Duk
Shin Hee-Young
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Abstract
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Transplantation-associated thrombotic microangiopathy (TA-TMA) is an uncommon but devastating complication in patients who undergo hematopoietic stem cell trans-plantation (SCT). However, the optimal treatment strategy for TA-TMA is unclear. We report a rare case of TA-TMA in a 39-month-old boy who underwent tandem autologous SCT (autoSCT) for high-risk medulloblastoma. TA-TMA developed 64 days after the sec-ond autoSCT with microangiopathic hemolytic anemia, fever, renal impairment, acute respiratory distress syndrome and posterior reversible encephalopathy syndrome. The patient recovered after plasmapheresis and methylprednisolone therapy. He had mild to moderate deficiency of a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS-13). The patient’s clinical course would suggest that plasmapheresis and methylprednisolone therapy could be a treatment option for TA-TMA. Early intervention is needed to aid the recovery of the patient who is suspected for TA-TMA.
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KEYWORD
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Thrombotic microangiopathy, Autologous stem cell transplantation, Plasmapheresis, Pediatrics
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