Acquired factor X deficiency developed four years after autologous transplantation in a patient with multiple myeloma associated with systemic AL amyloidosis

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  • TAKEMURA Tomonari
    Oncology Center, Hamamatsu University School of Medicine Division of Hematology, Seirei Mikatahara General Hospital
  • FUKATSU Yusuke
    Oncology Center, Hamamatsu University School of Medicine
  • NAGATA Yasuyuki
    Oncology Center, Hamamatsu University School of Medicine
  • ASAHINA Aya
    Oncology Center, Hamamatsu University School of Medicine
  • YOKOTA Daisuke
    Division of Hematology, Hamamatsu Medical Center
  • HIRANO Isao
    Division of Hematology, Hamamatsu Medical Center
  • YAGYU Tomohiro
    Oncology Center, Hamamatsu University School of Medicine
  • ONO Takaaki
    Department of Internal Medicine III, Hamamatsu University School of Medicine
  • KATSUMI Akira
    Department of Clinical Oncology, Hamamatsu University School of Medicine
  • OHNISHI Kazunori
    Oncology Center, Hamamatsu University School of Medicine Department of Clinical Oncology, Hamamatsu University School of Medicine

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Other Title
  • 全身性ALアミロイドーシスを合併した多発性骨髄腫に対する自家移植4年後に発症した後天性第X因子欠乏症
  • 症例報告 全身性ALアミロイドーシスを合併した多発性骨髄腫に対する自家移植4年後に発症した後天性第X因子欠乏症
  • ショウレイ ホウコク ゼンシンセイ AL アミロイドーシス オ ガッペイ シタ タハツセイ コツズイシュ ニ タイスル ジカ イショク 4ネンゴ ニ ハッショウ シタ コウテンセイ ダイX インシ ケツボウショウ

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Abstract

We describe a case of acquired factor X deficiency after high-dose melphalan with autologous stem cell transplantation (HDM/ASCT) for multiple myeloma (MM) with systemic AL amyloidosis. A 68-year-old woman with renal amyloidosis was diagnosed as having MM in 2007. She achieved a partial response after VAD (vincristine, adriamycin, dexamethasone) therapy and HDM/ASCT. In December 2011, coagulation tests revealed a prolonged prothrombin time (PT) of 17.6 sec and she was administered vitamin K. In January 2012, she received low anterior resection with colostomy for rectal cancer. She received fresh frozen plasma (FFP) infusion but the perioperative bleeding tendency persisted. In February 2012, she was referred from surgery for colostomy closure. She showed no progression of MM and had prolonged PT, corrected by mixing with normal plasma. Factor X activity was markedly decreased. She was diagnosed as having an acquired factor X deficiency and was given FFP infusion for colostomy closure. Although acquired factor X deficiency after HDM/ASCT for MM with systemic AL amyloidosis is rare, we should be aware of the possibility of this disease in MM patients with a bleeding tendency.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 55 (5), 558-562, 2014

    The Japanese Society of Hematology

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