論文

査読有り
2020年12月

Living-donor liver transplantation providing an adequate chemotherapy for a pediatric patient with anaplastic large cell lymphoma complicated with liver failure due to the aggravation of biliary hepatopathy by secondary hemophagocytic lymphohistiocytosis.

International journal of hematology
  • Kenichi Sakamoto
  • ,
  • Tomoo Osumi
  • ,
  • Satoshi Yoshimura
  • ,
  • Seiichi Shimizu
  • ,
  • Motohiro Kato
  • ,
  • Daisuke Tomizawa
  • ,
  • Akinari Fukuda
  • ,
  • Seisuke Sakamoto
  • ,
  • Noriyuki Nakano
  • ,
  • Takako Yoshioka
  • ,
  • Osamu Miyazaki
  • ,
  • Syunsuke Nosaka
  • ,
  • Takao Deguchi
  • ,
  • Nobutaka Kiyokawa
  • ,
  • Mureo Kasahara
  • ,
  • Kimikazu Matsumoto

112
6
開始ページ
900
終了ページ
905
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s12185-020-02949-z

Anaplastic large cell lymphoma (ALCL) accounts for 10-15% of childhood non-Hodgkin lymphoma cases; it is generally chemo-sensitive and is one of the most curable pediatric cancers. We report here a case of pediatric ALCL complicated with acute liver failure due to the aggravation of pre-existing biliary hepatopathy by lymphoma-associated hemophagocytic lymphohistiocytosis (HLH). Although the initial treatment response against ALCL was very good, poor and irreversible liver function due to biliary cirrhosis worsening by lymphoma-associated HLH prevented the patient from receiving further consolidation chemotherapies. To make matters worse, his condition was accompanied with intrahepatic fungal pseudoaneurysm and invasive fungal infection. Thus, we decided to perform an urgent living-donor liver transplantation from his father to correct the patient's liver function and make it possible to proceed with further ALCL therapy. After the living-donor liver transplantation, the patient successfully received consolidation therapy with brentuximab vedotin. To our knowledge, this may be an early reported case of a pediatric patient undergoing liver transplantation during treatment for ALCL. In most patients with HLH-associated ALCL, liver function improves when ALCL is controlled. However, acute liver failure is occasionally observed in HLH cases with pre-existing liver dysfunction. In such cases, liver transplantation should be considered to correct liver dysfunctions if the disease control of HLH is satisfactory.

リンク情報
DOI
https://doi.org/10.1007/s12185-020-02949-z
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32710432

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