RESUMO
Most human cases of West Nile virus infection are acquired via bites from an infected mosquito. In some cases, infection may also be transmitted by infected blood products or transplanted organs. There have been recent publications suggesting that chemotherapy and immunosuppression may increase a person's risks of developing central nervous system disease if the person is infected with the West Nile virus. Because patients undergoing hematopoietic stem cell transplantation not only are immunocompromised, but also receive multiple blood products, they are at a particularly high risk for acquiring symptomatic disease if exposed to the West Nile Virus. We describe here 2 patients who underwent hematopoietic transplantation at our institution and subsequently developed fatal West Nile virus infections.
Assuntos
Encefalite/virologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Febre do Nilo Ocidental/etiologia , Vírus do Nilo Ocidental , Idoso , Encefalite/prevenção & controle , Evolução Fatal , Humanos , Masculino , Pessoa de Meia-Idade , Febre do Nilo Ocidental/prevenção & controleRESUMO
A 64-year-old woman receiving intravenous chemotherapy for stage IIIB non-small cell lung cancer experienced acute arterial thrombosis of the distal radial and entire ulnar arteries with subsequent arterial occlusion of the right popliteal artery. Two separate arterial occlusions occurred after administration of cisplatin and etoposide chemotherapy; the second occlusion occurred after rechallenge with the second cycle of chemotherapy. Although venous thrombosis is more common in patients with cancer than in the general population, chemotherapy-induced arterial thrombosis rarely has been reported. To our knowledge, peripheral arterial occlusion after the first and second cycles of platinum-based chemotherapy has not been reported in the literature.
Assuntos
Antineoplásicos Fitogênicos/efeitos adversos , Antineoplásicos/efeitos adversos , Cisplatino/efeitos adversos , Etoposídeo/efeitos adversos , Trombose/induzido quimicamente , Angiografia , Antineoplásicos/uso terapêutico , Antineoplásicos Fitogênicos/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/complicações , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Cisplatino/uso terapêutico , Etoposídeo/uso terapêutico , Feminino , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/tratamento farmacológico , Pessoa de Meia-Idade , Dor/etiologia , Trombose/diagnóstico por imagem , Ativador de Plasminogênio Tecidual/metabolismoRESUMO
Thalidomide is the first drug in over 20 years to demonstrate clinically significant activity in patients with multiple myeloma. Although the survival rate has not improved with conventional chemotherapy over the last 30 years, thalidomide has produced favorable responses in patients for whom most available therapies have failed, such as those whose disease was resistant or relapsed after standard and high-dose treatments. Despite the risk of adverse effects such as sedation and constipation, thalidomide has become an alternative therapy for patients with relapsed or refractory disease. New trials with thalidomide administered alone and in combination with other agents seem to show promise in patients with multiple myeloma, as do preliminary studies with thalidomide derivatives.
