Antineoplastics
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Reactions 1495, p8 - 5 Apr 2014 S Antineoplastics Myelodysplastic syndrome and Takayasu arteritis: case report A 28-year-old woman developed therapy-related myelodysplastic syndrome (MDS) and Takayasu arteritis after receiving antineoplastics. The woman had a history of non-Hodgkin lymphoma at 10 years of age, for which she had received chemotherapy with vincristine, prednisolone, methotrexate * and cyclophosphamide * [dosages, routes and durations of treatment not stated]. She had also received radiotherapy, and had subsequently achieved complete remission. At 28 years of age, she developed pancytopenia, and was diagnosed with moderate aplastic anaemia. CT revealed left carotid artery stenosis. The woman received immunosuppressants; however, her haematological condition worsened, and regular transfusions were required from 30 years of age. At 33 years of age, bone marrow smear revealed erythroid cell dysplasia and trisomy 8. She was diagnosed with MDS, which appeared to be therapy- related, and was referred for a haematopoietic stem cell transplant. CT and MRI showed persistent left common carotid arterial wall thickening, and Takayasu arteritis was diagnosed. Cord blood transplantation was performed, after which she achieved neutrophil engraftment and 100% donor type chimerism. An episode of acute skin graft-versus-host disease resolved with steroid treatment, and she was discharged. At last follow-up, imaging revealed significant improvement in the left common carotid artery wall thickening, and she had no signs of MDS or arteritis relapse. The Takayasu arteritis was thought to have been potentially associated with her MDS as a paraneoplastic phenomenon. Author comment: "Since the chemotherapy for lymphoma was given at the age of 10 years, she appeared to have therapy-related MDS." "Remission of MDS may have contributed to attenuation of [Takayasu arteritis], which was potentially associated with MDS as a paraneoplastic phenomenon." * The abbreviations MTX and CY were used for these drugs in the original article; the authors have since confirmed that these abbreviations referred to methotrexate and cyclophosphamide, respectively. Kato H, et al. Significant improvement of Takayasu arteritis after cord blood transplantation in a patient with myelodysplastic syndrome. Bone Marrow Transplantation 49: 458-459, No. 3, Mar 2014. Available from: URL: http:// doi.org/10.1038/bmt.2013.198 - Japan 803101332 1 Reactions 5 Apr 2014 No. 1495 0114-9954/14/1495-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 1495, p8 - 5 Apr 2014
SAntineoplastics
Myelodysplastic syndrome and Takayasu arteritis:case report
A 28-year-old woman developed therapy-relatedmyelodysplastic syndrome (MDS) and Takayasu arteritis afterreceiving antineoplastics.
The woman had a history of non-Hodgkin lymphoma at10 years of age, for which she had received chemotherapywith vincristine, prednisolone, methotrexate* andcyclophosphamide*[dosages, routes and durations oftreatment not stated]. She had also received radiotherapy, andhad subsequently achieved complete remission. At 28 years ofage, she developed pancytopenia, and was diagnosed withmoderate aplastic anaemia. CT revealed left carotid arterystenosis.
The woman received immunosuppressants; however, herhaematological condition worsened, and regular transfusionswere required from 30 years of age. At 33 years of age, bonemarrow smear revealed erythroid cell dysplasia and trisomy 8.She was diagnosed with MDS, which appeared to be therapy-related, and was referred for a haematopoietic stem celltransplant. CT and MRI showed persistent left common carotidarterial wall thickening, and Takayasu arteritis was diagnosed.Cord blood transplantation was performed, after which sheachieved neutrophil engraftment and 100% donor typechimerism. An episode of acute skin graft-versus-host diseaseresolved with steroid treatment, and she was discharged. Atlast follow-up, imaging revealed significant improvement inthe left common carotid artery wall thickening, and she had nosigns of MDS or arteritis relapse. The Takayasu arteritis wasthought to have been potentially associated with her MDS as aparaneoplastic phenomenon.
Author comment: "Since the chemotherapy forlymphoma was given at the age of 10 years, she appeared tohave therapy-related MDS." "Remission of MDS may havecontributed to attenuation of [Takayasu arteritis], which waspotentially associated with MDS as a paraneoplasticphenomenon."
* The abbreviations MTX and CY were used for these drugs in theoriginal article; the authors have since confirmed that theseabbreviations referred to methotrexate and cyclophosphamide,respectively.
Kato H, et al. Significant improvement of Takayasu arteritis after cord bloodtransplantation in a patient with myelodysplastic syndrome. Bone MarrowTransplantation 49: 458-459, No. 3, Mar 2014. Available from: URL: http://doi.org/10.1038/bmt.2013.198 - Japan 803101332
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Reactions 5 Apr 2014 No. 14950114-9954/14/1495-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
