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01121 Journal of Nara Medical Association >
Vol.57 No.4-5 >
このアイテムの引用には次の識別子を使用してください:
http://hdl.handle.net/10564/265
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タイトル: | DEVELOPMENT OF AUTOIMMUNE THROMBOCYTOPENIA AFTER HIGH-DOSE CHEMOTHERAPY AND AUTOLOGOUS PERIPHERAL BLOOD STEM CELL SUPPORT FOR METASTATIC BREAST CANCER |
著者: | Kanno, Masatoshi![](/dspace/image/metalink/link_ja.gif) Nakamura, Shinobu Tsugawa, Koichiro Noguchi, Masakuni |
キーワード: | autoimmune thrombocytopenia breast cancer high-dose chemotherapy autologous stem cell transplantation |
発行日: | 2006年10月31日 |
出版者: | 奈良医学会 奈良県立医科大学 |
引用: | Journal of Nara Medical Association Vol.57 No.4-5 p.143-148 |
抄録: | Autoimmune thrombocytopenia (AT) occurs after not only allogeneic but
also autologous SCT following high-dose myeloablative chemotherapy against malignant
tumors. A 50-year-old woman was diagnosed with metastatic breast cancer (MBC) and
received myeloablative chemotherapy followed by autologous peripheral blood stem cell
transplantation. Purpura developed on day +40 after transplantation, and a diagnosis of
AT was made based on her bone marrow picture and elevation of serum PA-IgG level.
Her thrombocytopenia was refractory to treatment with high-dose intravenous immune
globulin (IVIG) and steroids. Although her platelet count recovered to within the normal
range after splenectomy, 14 months after receiving SCT she died of disseminated
intravascular coagulation syndrome caused by progression of cancer metastasis. There
have been 10 reported cases of AT developing after high-dose myeloablative
chemotherapy against malignant tumors followed by autologous SCT. We suggest that
the thrombocytopenia after engraftment was caused by activation of dormant
auto-immunity, which our patient potentially had, in conjunction with an insufficient
quantity and quality of suppressor T-cells before complete reconstruction of the immune
system after myeloablative conditioning. The clinical course of our patient was specific
and different from previously reported cases since a splenectomy was necessary due to
her thrombocytopenia being refractory to both steroid and IVIG therapy. |
URI: | http://hdl.handle.net/10564/265 |
ISSN: | 13450069 |
出現コレクション: | Vol.57 No.4-5
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