ABSTRACT
OBJECTIVES: The objective of this study is to evaluate the toxicity of autologous transplantation of non-frozen peripheral blood stem cells in Moroccan patients with multiple myeloma. MATERIAL AND METHODS: This was a bicentric retrospective study conducted in the Clinical Haematology Department of Mohammed V Military Teaching Hospital and at the Al Madina Clinic in Casablanca. The study period was from January 2015 to June 2019. All patients with multiple myeloma who had undergone an autologous peripheral stem cell transplant without freezing were included. Mobilisation was performed with lenograstim alone and the collected stem cells were stored for 24-48hours in a blood bank refrigerator at a temperature of 4°C. After standard conditioning with high-dose melphalan, the peripheral blood stem cells were reinjected 24 h following conditioning. RESULTS: Over the study period, 55 patients received an autologous transplant using non-frozen peripheral blood stem cells. The median richness of the CD34 cells collected was 4.5×106 CD34/kg (range: 2-12.2). The time required for neutrophil recovery was 12 days (range: 7-19). The time required for platelet recovery was 14 days (range: 9-32). The mortality rate within 100 days post-transplant was 3.6%. We did not observe any cases of graft failure. CONCLUSION: Our study finds good feasibility and low toxicity of autologous peripheral stem cell transplantation without freezing in patients with multiple myeloma.
Subject(s)
Blood Preservation , Multiple Myeloma/therapy , Peripheral Blood Stem Cell Transplantation/methods , Adult , Aged , Blood Cell Count , Blood Preservation/methods , Female , Graft Survival , Hematopoietic Stem Cell Mobilization , Humans , Lenograstim/pharmacology , Male , Melphalan/pharmacology , Middle Aged , Morocco , Multiple Myeloma/blood , Peripheral Blood Stem Cell Transplantation/adverse effects , Retrospective Studies , Transplantation Conditioning/adverse effects , Transplantation, AutologousABSTRACT
Thrombosis and hemorrhage are two opposing manifestations of multiple myeloma. These hemostatic disorders are present in less than 12% of patients at diagnosis and involve various pathophysiological mechanisms. We report the case of a 39-year-old patient with multiple myeloma revealed by the association of a hemorrhagic syndrome and deep vein thrombosis related to a hypoprothrombinemia-anticoagulant lupus syndrome.
Subject(s)
Multiple Myeloma/diagnosis , Adult , Hemorrhage/etiology , Humans , Hypoprothrombinemias/etiology , Immunoglobulin Light Chains , Lupus Coagulation Inhibitor , Male , Multiple Myeloma/complications , Syndrome , Thrombosis/etiologySubject(s)
Antibiotics, Antineoplastic/adverse effects , Bleomycin/adverse effects , Lung Diseases, Interstitial/chemically induced , Mediastinal Emphysema/chemically induced , Pneumothorax/chemically induced , Antibiotics, Antineoplastic/therapeutic use , Bleomycin/therapeutic use , Fatal Outcome , Hodgkin Disease/drug therapy , Humans , Lung/pathology , Lung Diseases, Interstitial/complications , Male , Mediastinal Emphysema/complications , Middle Aged , Pneumothorax/complications , Tomography, X-Ray ComputedSubject(s)
Acute Pain/etiology , Platelet Transfusion/adverse effects , Transfusion Reaction/etiology , Anemia, Aplastic/therapy , Bone Marrow Transplantation , Dyspnea/etiology , Humans , Hypotension/etiology , Male , Middle Aged , Plateletpheresis/instrumentation , Tachycardia/etiology , Thrombocytopenia/etiology , Thrombocytopenia/therapySubject(s)
Candidiasis, Invasive/diagnostic imaging , Fluorine Radioisotopes , Fluorodeoxyglucose F18 , Hepatitis/diagnostic imaging , Multimodal Imaging , Positron-Emission Tomography , Radiopharmaceuticals , Splenic Diseases/diagnostic imaging , Tomography, X-Ray Computed , Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Candidiasis, Invasive/drug therapy , Candidiasis, Invasive/etiology , Chemotherapy-Induced Febrile Neutropenia/complications , Cytarabine/administration & dosage , Cytarabine/adverse effects , Daunorubicin/administration & dosage , Daunorubicin/adverse effects , Hepatitis/drug therapy , Hepatitis/etiology , Humans , Immunocompromised Host , Leukemia, Myeloid, Acute/complications , Leukemia, Myeloid, Acute/drug therapy , Male , Middle Aged , Splenic Diseases/drug therapy , Splenic Diseases/etiologyABSTRACT
Introduction. We report the case of a Bing and Neel syndrome revealed by an isolated left ptosis. Case Report. a 57-year-old man was followed up since October 2003 for a typical Waldenström's macroglobulinemia. A first complete remission was obtained with chlorambucil. In August 2004, he relapsed. A second complete remission was obtained with RFC chemotherapy regimen (rituximab, fludarabine, and cyclophosphamide). In October 2009, the patient presented with an isolated left ptosis revealing a Bing and Neel syndrome. The diagnosis was suspected on MRI and confirmed by the detection in the CSF of a monoclonal IgM similar to the one found in the plasma. A quite good partial remission has been obtained after one course of RDHAP (rituximab, dexamethasone, cytarabine, and cisplatin) and 3 courses of RDHOx (rituximab, dexamethasone, cytarabine, and oxaliplatin), in addition to ten intrahectal chemotherapy injections. The treatment was followed by intensification and autologous stem cell transplantation. At D58, the patient died due to a septic shock. Conclusion. BNS is a rare and potentially treatable complication of WM. It should be considered in patients with neurologic symptoms and a history of WM.
