Two Cases of Intractable Pneumothorax in Childhood after Bone Marrow Transplantation.
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We report two cases of pneumothorax after allogeneic bone marrow transplantation (BMT). The first case is that of a 17-year-old girl diagnosed with acute lymphoblastic leukemia. During her second remission, she received a BMT from her HLA-identical brother after cyclophosphamide and total body irradiation. She suffered from grade II acute GVHD and interstitial pneumonitis. Exertional dyspnea due to probable bronchiolitis obliterans appeared followed by pneumothorax occurred 3 years after BMT and she died 3 months later. The second case is that of a 14-year-old boy diagnosed with acute promyelocytic leukemia. He received autologous blood stem cell transplantation during his first remmission, and allogeneic bone marrow from his HLA 1 locus-mismatched uncle during his second remission with busulfan, cyclophosphamide and total lymph node irradiation after induction therapy using ATRA. He suffered from grade III acute GVHD, extensive chronic GVHD, and pulmonary aspergillosis. Pneumothorax and multiple lung bullae were noted 1 1/2 years after BMT and he died 4 months later. Both cases had risk factors of pneumothorax which were allogeneic BMT combined with irradiation, acute and chronic GVHD, and pneumonitis. Lung irradiation is supposed to be a major risk factor of pneumothorax, and its use should be limited.
- 特定非営利活動法人 日本小児血液・がん学会の論文
特定非営利活動法人 日本小児血液・がん学会 | 論文
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