Pulmonary artery thromboembolism during the reinduction phase in a patient with acute lymphoblastic leukemia

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  • 再寛解導入療法中に肺動脈血栓症を発症した急性リンパ性白血病例

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<p>A 3-year-old boy with B-precursor acute lymphoblastic leukemia developed pulmonary artery thromboembolism (PTE) during the reinduction phase. We had used a peripherally inserted central catheter (PICC) for 6 months since the start of the induction therapy. An increase in D-dimer concentration and thrombotic blockade of the PICC were observed before PTE development. After intravenous administration of unfractionated heparin followed by the removal of the PICC, his clinical symptoms improved in two weeks with warfarin. We reinserted a PICC before the second reinduction phase with warfarin, we continued his subsequent planned chemotherapy without the recurrence of thromboembolism. His clinical course suggests that PTE was caused by PICC-related thrombosis. We should pay careful attention to central venous catheter selection, insertion sites, and long-term management because of the high incidence of thromboembolism associated with PICC use.</p>

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