Veno-venous extracorporeal membrane oxygenation for capillary leak syndrome during induction chemotherapy in acute myeloid leukemia
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- OKAMURA Tadashi
- Department of Hematology/Oncology, Wakayama Medical University
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- MURATA Shogo
- Department of Hematology/Oncology, Wakayama Medical University
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- MIYAMOTO Kyohei
- Department of Emergency and Critical Care Medicine, Wakayama Medical University
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- TANE Misato
- Department of Hematology/Oncology, Wakayama Medical University
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- OKABE Yuka
- Department of Hematology/Oncology, Wakayama Medical University
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- TAKEDA Satomi
- Department of Hematology/Oncology, Wakayama Medical University
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- TABATA Shotaro
- Department of Hematology/Oncology, Wakayama Medical University
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- KOSAKO Hideki
- Department of Hematology/Oncology, Wakayama Medical University
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- HORI Yoshikazu
- Department of Hematology/Oncology, Wakayama Medical University
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- YAMASHITA Yusuke
- Department of Hematology/Oncology, Wakayama Medical University
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- MUSHINO Toshiki
- Department of Hematology/Oncology, Wakayama Medical University
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- HOSOI Hiroki
- Department of Hematology/Oncology, Wakayama Medical University
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- SONOKI Takashi
- Department of Hematology/Oncology, Wakayama Medical University
Bibliographic Information
- Other Title
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- 寛解導入療法中に静脈-静脈体外式膜型人工肺によりcapillary leak syndromeから回復した急性骨髄性白血病
Abstract
<p>A 44-year-old woman was diagnosed with acute myeloid leukemia (RUNX1::RUNX1T1 translocation) and received induction chemotherapy with idarubicin hydrochloride and cytosine arabinoside. The pneumonia that had been present since admission worsened, and a drug-induced skin rash appeared. On day 17, she presented with respiratory failure and shock, complicated by hemoconcentration and hypoalbuminemia. This was considered capillary leak syndrome due to pneumonia and drug allergy, so she was started on pulse steroid therapy and IVIG, and was intubated on the same day. On day 18, venovenous-extracorporeal membrane oxygenation (VV-ECMO) was started due to worsening blood gas parameters despite ventilatory management. Bronchoalveolar lavage fluid was serous, and both blood and sputum cultures yielded negative. The patient was weaned from VV-ECMO on day 26 as the pneumonia improved with recovery of hematopoiesis. She was disoriented, and a CT scan on day 28 revealed cerebral hemorrhage. Her strength recovered with rehabilitation. After induction chemotherapy, RUNX1::RUNX1T1 mRNA was not detected in bone marrow. The patient received consolidation chemotherapy, and has maintained complete remission. Severe respiratory failure during induction chemotherapy for acute leukemia can be fatal, but VV-ECMO may be lifesaving.</p>
Journal
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- Rinsho Ketsueki
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Rinsho Ketsueki 65 (3), 169-174, 2024
The Japanese Society of Hematology