EurekaMag.com logo
+ Site Statistics
References:
53,623,987
Abstracts:
29,492,080
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on LinkedInFollow on LinkedIn

+ Translate

Treatment of a Case of Non-Hodgkin Lymphoma with Pathologic Fracture of Multiple Thoracic Vertebra and Paralysis of Legs with Autologous Transplantation of Combination of Bone Marrow Cells and Peripheral Blood Progenitor Cells



Treatment of a Case of Non-Hodgkin Lymphoma with Pathologic Fracture of Multiple Thoracic Vertebra and Paralysis of Legs with Autologous Transplantation of Combination of Bone Marrow Cells and Peripheral Blood Progenitor Cells



Blood 100(11): Abstract No 5144, November 16



The patient is a Chinese boy, 16 years. He had severe pain on his back, high fever, paralysis of legs for 2 months and hospitalized on Oct. 22, 1996. CT-scanner showed that he had cut down fracture of his thoracic vertebra 3,4,10, resulting paralysis of two legs, pathologic destroy of thoracic vertebra 2 to 10 and vertebra lumber 2 to 4. After the operation for reducing pressure of vertebral tube, he was diagnosed as high-malignant, B-large cell Non-Hodgkin lymphoma, IV phase, B group. His blood test showed HBsAg (+).He received one course of CHOP regimen immediately. Then he had received 4 courses of CHOP+E (VP-16 1.8mg/kg, d1, d3, d5). After the two courses of higher dose of CAOPE regimens (CY 1400mg/m2, Ara-C 1400mg /m2, VCR, Pred, VP-16), his 2.09x108/kg of bone marrow mononuclear cells was harvested and cryopreserved with dimethyl sulfoxide(DMSO) in fluid nitrogen (-196degreeC)after moving red cell. After mobilization of G-CSF (Kirin, CO, Japan)300mug/d, d1-d3, his 5.14x108/kg of peripheral blood mononuclear cells which included CD34+ cells of 2.01x106/kg were collected by COBE Spectra blood separator (COBE, CO, Lakewood) and cryopreserved. The conditional regimen was Cy 120mg/kg and total body irradiation (60CO TBI) 800 cGY(lung 700 cGY, local pathologic thoracic and lumber vertebra 1050 cGY). He was treated with acyclovir and high-dose intravenous immunoglobulin for prophylactic virus infection. He had severe head pain and severe hemoglubinuria when he received transfusion of bone marrow cryopreserved cells on Jun.16, 1997. His hemoglubinuria was completely controlled by high-dose DXM (1.3mg/kg). His WBC decreased to 0 at +5d and recovered to 0.7x108/L at +12d. He can walk by himself from the isolation room at +17d. After discharged from hospital he received two courses of 60CO irradiation on local pathologic vertebra. The total dose was 6500 cGY. He has been disease-free survival for 6 years. We have some experiences (1) Some Lymphoma patients with thoracic vertebra with reversible paralysis can also be selected to transplant. We pay more attention to moving the body in case of severe vertebra fracture when carrying the patient out to TBI. It has key role for reversible paralysis that to give intensive consolidation therapy such as transplantation. (2) Autologous transplantation of combination of bone marrow cells and peripheral blood progenitor cells has some advantages such as rapid hematopoietic recovery. The reasons are closely related to double dosage of infusion cells number, also maybe to different characteristics of two kinds of progenitor cells such as bone marrow stromal cells. (3) HD-irradiation therapy after transplantation is also very important for cure of patient with pathologic bone fracture of vertebra. The patient has received total dose of 6500 cGy in local pathologic vertebra. (4) Could a hepatitis B virus carrier patient receive hematopoietic cells transplant? Some hematologists and oncologists thought chemotherapy results in active of hepatitis B virus. Why this patient did not acute hepatitis appearing during transplantation? Perhaps it is related to give treatment of acyclovir and high-dose intravenous immunoglobulin.

(PDF 0-2 workdays service: $29.90)

Accession: 035980660

Download citation: RISBibTeXText



Related references

Clinical implications of molecular monitoring in patients with low-grade Non-Hodgkin lymphoma after transplantation of autologous bone marrow or peripheral blood progenitor cells. British Journal of Haematology 93(SUPPL 2): 303, 1996

Autologous peripheral blood progenitor cells transplantation in patients with malignant lymphoma A retrospective cost comparison with autologous bone marrow transplantation. British Journal of Haematology 87(SUPPL 1): 24, 1994

Economic analysis of a randomized clinical trial to compare filgrastim-mobilized peripheral-blood progenitor-cell transplantation and autologous bone marrow transplantation in patients with Hodgkin's and non-Hodgkin's lymphoma. Journal of Clinical Oncology 15(1): 5-10, 1997

Costs of peripheral blood progenitor cell transplantation using whole blood mobilised by filgrastim as compared with autologous bone marrow transplantation in non-Hodgkin's lymphoma. Pharmacoeconomics 15(3): 305-311, 1999

Autologous peripheral blood progenitor cell transplantation for non-Hodgkin's lymphoma with extensive bone marrow necrosis. Bone Marrow Transplantation 19(10): 1037-1039, 1997

Combined autologous peripheral blood progenitor cells and bone marrow stem cells transplantation in the treatment of hematological malignancies. Experimental Hematology (Charlottesville) 25(8): 819, 1997

Hematologic recovery and survival of lymphoma patients after autologous stem-cell transplantation: comparison of bone marrow and peripheral blood progenitor cells. Leukemia & Lymphoma 22(5-6): 449-456, 1996

High degree of occult tumor contamination in bone marrow and peripheral blood stem cells of patients undergoing autologous transplantation for non-Hodgkin's lymphoma. Biology of Blood and Marrow Transplantation 2(1): 37-43, 1996

Peripheral-blood stem-cell transplantation versus autologous bone marrow transplantation in Hodgkin's and non-Hodgkin's lymphomas: a new matched-pair analysis of the European Group for Blood and Marrow Transplantation Registry Data. Lymphoma Working Party of the European Group for Blood and Marrow Transplantation. Journal of Clinical Oncology 15(2): 509-517, 1997

Treatment of patients with relapsed and resistant Hodgkin and non-Hodgkin lymphoma using dexamethason; BCNU, melphalan, VP-16, ARA-C with autologous bone marrow or peripheral blood stem cell transplantation. British Journal of Haematology 93(SUPPL 2): 82, 1996

G-CSF primed peripheral blood progenitor cells in autologous bone marrow transplantation: parameters affecting bone marrow engraftment. Bone Marrow Transplantation 12(6): 609-614, 1993

Mobilization/transplantation of peripheral blood progenitor cells for aggressive non-Hodgkin's lymphoma with marrow involvement. Leukemia & Lymphoma 26 Suppl 1: 83-88, 1998

Mobilization/transplantation of peripheral blood progenitor cells for aggressive non-Hodgkin's lymphoma with marrow involvement. Leukemia 10 Suppl 2: S88-S91, 1996

Comparative study of hematopoiesis after autologous bone marrow transplantation or autologous peripheral blood stem cells transplantation in 65 patients with non-Hodgkins lymphoma. Blood 84(10 SUPPL 1): 706A, 1994

Cost analysis and quality of life assessment comparing patients undergoing autologous peripheral blood stem cell transplantation or autologous bone marrow transplantation for refractory or relapsed non-Hodgkin's lymphoma or Hodgkin's disease: A prospective randomised trial. European Journal of Cancer 37(14): 1781-1789, September, 2001