Successful treatment with combined anti-thymocyte globulin and methylprednisolone for bronchiolitis obliterans after allogeneic bone marrow transplantation in a child with chronic myelogenous leukemia

• SANO Hideki

  Department of Pediatrics, Fukushima Medical University School of Medicine

• KIKUTA Atsushi

  Department of Pediatrics, Fukushima Medical University School of Medicine

• ITO Masaki

  Department of Pediatrics, Fukushima Medical University School of Medicine

• NEMOTO Kenji

  Department of Pediatrics, Fukushima Medical University School of Medicine

• HOJO Hiroshi

  First Department of Pathology, Fukushima Medical University School of Medicine

• OHTO Hitoshi

  Division of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine

Bibliographic Information

Other Title

• 同種骨髄移植後の閉塞性細気管支炎に対してメチルプレドニゾロン併用抗胸腺細胞グロブリン(ATG)療法が奏効した小児慢性骨髄性白血病
• 症例 同種骨髄移植後の閉塞性細気管支炎に対してメチルプレドニゾロン併用抗胸腺細胞グロブリン(ATG)療法が奏効した小児慢性骨髄性白血病
• ショウレイ ドウシュ コツズイ イショク ゴ ノ ヘイソクセイサイキカンシエン ニ タイシテ メチルプレドニゾロン ヘイヨウ コウキョウセン サイボウ グロブリン ATG リョウホウ ガ ソウコウ シタ ショウニ マンセイ コツズイセイ ハッケツビョウ

Abstract

A 9-year-old boy with secondary chronic myelogenous leukemia after treatment of acute lymphoblastic leukemia underwent allogeneic bone marrow transplantation (BMT) from an HLA-identical sibling in December 1998. Grade II acute GVHD developed on day 24 and chronic GVHD developed 5 months after BMT. Cough and dyspnea appeared 9 months after BMT. Despite administration of tacrolimus and methylprednisolone (m-PSL) pulse therapy, the dyspnea gradually increased in severity. Bronchiolitis obliterans was diagnosed on the basis of lung biopsy in January 1999. Because renal dysfunction made it difficult to continue the use of tacrolimus, we attempted antithymocyte globulin (ATG) +m-PSL therapy. Major BCR/ABL mRNA was transiently positive on RT-PCR after the ATG+m-PSL therapy, but no severe complications were observed. A decreasing V₅₀/V₂₅ level and increasing peak flow value were observed in respiratory function tests after ATG+m-PSL therapy, and the patient is currently free of dyspnea. Our findings suggest that ATG+m-PSL therapy is benefical for patients with drug-resistant bronchiolitis obliterans after BMT.

Journal

• Rinsho Ketsueki

  Rinsho Ketsueki 43 (1), 23-28, 2002

  The Japanese Society of Hematology

Keywords

• Bronchiolitis obliterans
• Anti-thymocyte globulin
• Methylprednisolone
• Chronic GVHD

Details

• CRID: 1390282680010733696
• NII Article ID: 10008355747
• NII Book ID: AN00252940
• DOI: 10.11406/rinketsu.43.23
• COI: 1:STN:280:DC%2BD387jtlerug%3D%3D
• ISSN: 18820824
• ISSN: 04851439
• NDL BIB ID: 6293723
• PubMed: 11868361
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I6293723
• Web Site: https://search.jamas.or.jp/link/ui/2002150897
• Text Lang: ja
• Data Source:
  • JaLC
  • NDL
  • PubMed
  • CiNii Articles
• Abstract License Flag: Disallowed