Refractory chronic GVHD emerging after splenectomy in a marrow transplant recipient with accelerated phase CML
| dc.contributor.author | Rodrigues, C. A. | |
| dc.contributor.author | Fermino, Fabiana Aidar [UNIFESP] | |
| dc.contributor.author | Vasconcelos, Yuri [UNIFESP] | |
| dc.contributor.author | Oliveira, JSR de | |
| dc.contributor.institution | Universidade Federal de São Paulo (UNIFESP) | |
| dc.date.accessioned | 2016-01-24T12:33:57Z | |
| dc.date.available | 2016-01-24T12:33:57Z | |
| dc.date.issued | 2003-08-01 | |
| dc.description.abstract | We report a 39-year-old female patient who underwent HLA-identical sibling allogeneic BMT for CML in accelerated phase. Severe pancytopenia refractory to G-CSF associated with progressive splenomegaly and RBC/ platelet transfusion dependency were present from day + 60 after BMT. MRD assessed by FISH and RT-PCR multiplex for BCR-ABL rearrangement was negative, and complete chimerism was documented by VNTR on days + 100, + 180, + 360 and 2 years after BMT. Splenectomy was performed on day + 225 and pancytopenia resolved but chronic extensive graft-versus-host disease developed, with hepatic cholestasis, diffuse scleroderma and sicca-like syndrome. She was sequentially and progressively treated with different immunosuppressive therapy combinations with no clear benefit. On day + 940, she presented with infection over the previously present ulcers on both limbs, which culminated in septic shock and death on day + 1041. We conclude that, although splenectomy may reverse poor graft function after allogeneic BMT, hyposplenism may trigger or worsen chronic extensive GVHD leading to increased morbidity and mortality. | en |
| dc.description.affiliation | Hosp São Paulo, São Paulo, Brazil | |
| dc.description.affiliationUnifesp | Hosp São Paulo, São Paulo, Brazil | |
| dc.description.source | Web of Science | |
| dc.format.extent | 333-335 | |
| dc.identifier | http://dx.doi.org/10.1038/sj.bmt.1704122 | |
| dc.identifier.citation | Bone Marrow Transplantation. London: Nature Publishing Group, v. 32, n. 3, p. 333-335, 2003. | |
| dc.identifier.doi | 10.1038/sj.bmt.1704122 | |
| dc.identifier.issn | 0268-3369 | |
| dc.identifier.uri | http://repositorio.unifesp.br/handle/11600/27331 | |
| dc.identifier.wos | WOS:000184317900015 | |
| dc.language.iso | eng | |
| dc.publisher | Nature Publishing Group | |
| dc.relation.ispartof | Bone Marrow Transplantation | |
| dc.rights | info:eu-repo/semantics/openAccess | |
| dc.subject | BMT | en |
| dc.subject | chronic GVHD | en |
| dc.subject | splenectomy | en |
| dc.title | Refractory chronic GVHD emerging after splenectomy in a marrow transplant recipient with accelerated phase CML | en |
| dc.type | info:eu-repo/semantics/article |