一名接受沙利度胺治疗的原发性浆细胞白血病患者出现持续性室性心动过速。
Sustained ventricular tachycardia in a thalidomide-treated patient with primary plasma-cell leukemia.
作者信息
Ballanti Stelvio, Mastrodicasa Elena, Bolli Niccolò, Lotti Flavia, Capolsini Ilaria, Berchicci Laura, Merigiola Carla, Giordano Giampiero, Tabilio Antonio
机构信息
Institute of Hematology, Perugia University and IbiT Foundation, Perugia, Italy.
出版信息
Nat Clin Pract Oncol. 2007 Dec;4(12):722-5. doi: 10.1038/ncponc1008.
BACKGROUND
A 68-year-old man diagnosed with primary plasma-cell leukemia was given thalidomide maintenance treatment for his disease. He had previously failed induction therapy with cyclophosphamide, vincristine, adriamycin, and dexamethasone, but achieved complete remission after melphalan therapy. Multiple syncopal episodes started to occur during thalidomide treatment, and a Holter electrocardiogram showed multiple abnormalities, with an episode of sustained ventricular tachycardia.
INVESTIGATIONS
Blood tests, peripheral blood smear, bone-marrow biopsy and aspirate, Holter electrocardiogram.
DIAGNOSIS
Sustained ventricular tachycardia possibly owing to thalidomide treatment.
MANAGEMENT
Thalidomide withdrawal, dexamethasone maintenance therapy, monthly oral courses of combined melphalan and prednisone, salvage therapy with bortezomib.
背景
一名68岁男性被诊断为原发性浆细胞白血病，接受沙利度胺维持治疗。他之前接受环磷酰胺、长春新碱、阿霉素和地塞米松诱导治疗失败，但美法仑治疗后达到完全缓解。沙利度胺治疗期间开始出现多次晕厥发作，动态心电图显示多项异常，并有一次持续性室性心动过速发作。
检查
血液检查、外周血涂片、骨髓活检及抽吸、动态心电图。
诊断
可能因沙利度胺治疗导致的持续性室性心动过速。
治疗
停用沙利度胺，地塞米松维持治疗，每月口服美法仑和泼尼松联合疗程，硼替佐米挽救治疗。
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