Wiener klinische Wochenschrift

, Volume 123, Issue 11–12, pp 354–358 | Cite as

Successful allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia during respiratory failure and invasive mechanical ventilation

  • Alexandra Boehm
  • Werner Rabitsch
  • Gottfried J. Locker
  • Nina Worel
  • Oliver Robak
  • Klaus F. Laczika
  • Thomas Staudinger
  • Andja Bojic
  • Viktoria Siersch
  • Peter Valent
  • Wolfgang R. Sperr
Original article

Summary

Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative treatment option for various hematologic disorders. However, life-threatening adverse events resulting from treatment-related toxicity, severe infections, and/or graft-versus-host disease (GvHD) can occur. We report on a 64-year-old patient suffering from secondary acute myeloid leukemia (AML) who underwent successful allogeneic HSCT while on invasive mandatory ventilation (IMV). The patient received reduced intensity conditioning (RIC) according to the FLAMSA-protocol. Acute respiratory failure occurred one day before scheduled HSCT. Following emergency endotracheal intubation the patient was transferred to the intensive care unit (ICU). Because of respiratory deterioration, stem cell infusion was postponed. After stabilization of respiratory parameters, HSCT was performed during IMV which was continued for seven days. Following hematopoietic regeneration the patient was discharged in good condition on day 35 after HSCT. This case illustrates that intubation and mechanical ventilation do not necessarily exclude leukemic patients from HSCT.

Keywords

Allogeneic stem cell transplantation Invasive mechanical ventilation Acute myeloid leukemia 

Erfolgreiche allogene Blutstammzelltransplantation bei akuter myeloischer Leukämie während respiratorischem Versagen und invasiver Beatmung

Zusammenfassung

Die allogene hämatopoetische Stammzelltransplantation (HSCT) ist eine potentiell kurative Behandlungsoption für viele hämatologische Erkrankungen. Durch die Behandlungs-assoziierte Toxizität, schwere Infektionen und/oder die Spender-gegen-Empfänger-Reaktion (GvHD) kann es allerdings zum Auftreten von lebensbedrohlichen Komplikationen kommen. Wir berichten über eine 64-jährige Patientin mit sekundärer akuter myeloischer Leukämie (AML), bei der unter invasiver mechanischer Beatmung erfolgreich eine HSCT durchgeführt werden konnte. Die Patientin erhielt eine dosisreduzierte Konditionierungschemotherapie nach dem FLAMSA-Protokoll. Am Tag vor der geplanten HSCT kam es zum Auftreten eines respiratorischen Versagens, weshalb die Patientin nach einer akut notwendigen Intubation an die Intensivstation (ICU) transferiert wurde. Aufgrund der respiratorischen Verschlechterung musste die Stammzellinfusion verschoben werden. Nachdem die Patientin wiederum stabilisiert werden konnte, wurde die HSCT durchgeführt und die mechanische Beatmung für insgesamt 7 Tage vollzogen. Nach der hämatopoetischen Regeneration konnte die Patientin in gutem Allgemeinzustand am Tag 35 nach HSCT entlassen werden. Dieser Fallbericht zeigt, dass Intubation und Beatmung keine absoluten Kontraindikationen für die Durchführung einer HSCT bei Leukämiepatienten sind.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Alexandra Boehm
    • 1
  • Werner Rabitsch
    • 1
  • Gottfried J. Locker
    • 2
  • Nina Worel
    • 3
  • Oliver Robak
    • 2
  • Klaus F. Laczika
    • 2
  • Thomas Staudinger
    • 2
  • Andja Bojic
    • 2
  • Viktoria Siersch
    • 1
  • Peter Valent
    • 4
    • 5
  • Wolfgang R. Sperr
    • 4
  1. 1.Department of Internal Medicine I, Bone Marrow Transplantation UnitMedical University of ViennaViennaAustria
  2. 2.Department of Internal Medicine I, Intensive Care UnitMedical University of ViennaViennaAustria
  3. 3.Department for Blood Group Serology and Transfusion MedicineMedical University of ViennaViennaAustria
  4. 4.Department of Internal Medicine I, Division of Hematology & HemostaseologyMedical University of ViennaViennaAustria
  5. 5.Ludwig Boltzmann Cluster OncologyViennaAustria

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