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Successful management of multilineage autoimmune cytopenia complicated with severe infection and deep vein thrombosis in a patient with Hodgkin lymphoma post‐autologous hematopoietic stem cell transplantation
Author(s) -
Hsu WanYi,
Chiou ShyhShin,
Liao YuMei,
Shu HsiuLan,
Zeng YuSheng,
Wong CheongChew,
Lin PeiChin
Publication year - 2016
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12644
Subject(s) - medicine , pancytopenia , cytopenia , rituximab , lymphoma , deep vein , hematopoietic stem cell transplantation , transplantation , thrombosis , surgery , gastroenterology , bone marrow
Autoimmune cytopenia (AIHA, AITP or AIN) were uncommon paraneoplastic manifestations of HL and have been recognized in patients after HSCT with dismal outcome. We presented a case of 16‐yr‐old male with Hodgkin's lymphoma who developed severe AIC involving all three cell lineages after autologus bone marrow transplantation. No disease relapse was noted. Treatments with steroid, IVIG and immunosuppresants were in vain and the disease course was complicated with sepsis and deep vein thrombosis. Rituximab was administered along with broad‐spectrum antibiotics and low‐molecular weight heparin. The condition became stable and pancytopenia recovered after four doses of rituximab treatment. Severe multi‐lineage AIC post HSCT is usually refractory to first‐line treatment and difficult to manage. Second‐line treatment, such as rituximab, and dedicated care for pancytopenia‐induced or treatment‐related complications may provide a better outcome.