RESUMO
We report the case of an 18-year-old patient who received an allogeneic bone marrow transplant from an HLA-identical unrelated donor for a Ph+ acute lymphoblastic leukemia, in his third complete remission. Cyclophosphamide and busulfan were used as conditioning treatment. Acute graft-versus-host disease developed on day +9, and the response to adequate treatment (steroids) was favourable. On day +45 the patient developed an acute severe haemorhragic cystitis, and BK polyomavirus was demonstrated in urine samples using electron microscopy and polymerase chain reaction. Urinary symptoms did not improve in spite of palliative treatment, but a response was evident after 2 weeks of cidofovir treatment.
Assuntos
Antivirais/uso terapêutico , Cistite/tratamento farmacológico , Citosina/uso terapêutico , Organofosfonatos , Compostos Organofosforados/uso terapêutico , Infecções por Polyomavirus/tratamento farmacológico , Infecções Tumorais por Vírus/tratamento farmacológico , Adolescente , Transplante de Medula Óssea/efeitos adversos , Transplante de Medula Óssea/métodos , Cidofovir , Cistite/complicações , Cistite/diagnóstico , Citosina/análogos & derivados , Hemorragia/etiologia , Humanos , Masculino , Polyomavirus/isolamento & purificação , Infecções por Polyomavirus/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Resultado do Tratamento , Infecções Tumorais por Vírus/diagnósticoRESUMO
We report on a case of pyridoxine refractory hereditary sideroblastic anaemia (HSA) in a 19-year-old man who underwent peripheral blood stem cell transplantation (PBSCT) from his HLA-identical brother. By using short tandem repeat polymorphism, 100% donor cells were observed in peripheral blood on day +21; bone marrow showed mixed chimaerism from day +21 to day +221, when 100% cells of donor origin were observed. The patient developed extensive chronic graft-versus-host disease with favourable response to treatment. When the haemoglobin range was normal, a programme of phlebotomies reduced serum ferritin levels. Three years after transplantation, the patient has an ECOG rating of 0, with completely normal haemoglobin values (15 g/dl). To our knowledge, this is the first PBSCT reported in a case of hereditary sideroblastic anaemia.