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Melphalan Culprit or Confounder in Acute Encephalopathy during Autologous Hematopoietic Stem Cell Transplantation?美法仑是自体造血干细胞移植期间急性脑病的罪魁祸首还是混淆因素?
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[Autologous haematopoietic stem cell transplantation in patients with multiple myeloma complicated by dialysis-dependent renal failure].[自体造血干细胞移植治疗合并依赖透析的肾衰竭的多发性骨髓瘤患者]
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Busulfan, Melphalan, and Bortezomib versus High-Dose Melphalan as a Conditioning Regimen for Autologous Hematopoietic Stem Cell Transplantation in Multiple Myeloma.白消安、美法仑和硼替佐米与大剂量美法仑作为多发性骨髓瘤自体造血干细胞移植预处理方案的比较
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A Phase I/II Study of Escalating Doses of Bortezomib in Conjunction with High-Dose Melphalan as a Conditioning Regimen for Salvage Autologous Peripheral Blood Stem Cell Transplantation in Patients with Multiple Myeloma.一项关于递增剂量硼替佐米联合大剂量美法仑作为多发性骨髓瘤患者挽救性自体外周血干细胞移植预处理方案的I/II期研究。
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引用本文的文献

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How we manage autologous stem cell transplantation for patients with multiple myeloma.我们如何为多发性骨髓瘤患者管理自体干细胞移植。
Blood. 2014 Aug 7;124(6):882-90. doi: 10.1182/blood-2014-03-544759. Epub 2014 Jun 27.

本文引用的文献

1
Pre- and post-transplantation risk factors for delirium onset and severity in patients undergoing hematopoietic stem-cell transplantation.造血干细胞移植患者发生谵妄及严重程度的移植前后危险因素。
J Clin Oncol. 2011 Mar 1;29(7):895-901. doi: 10.1200/JCO.2010.28.4521. Epub 2011 Jan 24.
2
Wernicke's encephalopathy following allogeneic hematopoietic stem cell transplantation.异基因造血干细胞移植后韦尼克脑病
Korean J Hematol. 2010 Dec;45(4):279-81. doi: 10.5045/kjh.2010.45.4.279. Epub 2010 Dec 31.
3
Treatment of severe sepsis and septic shock by CHDF using a PMMA membrane hemofilter as a cytokine modulator.使用聚甲基丙烯酸甲酯(PMMA)膜血液滤过器作为细胞因子调节剂,通过连续性血液透析滤过(CHDF)治疗严重脓毒症和脓毒性休克。
Contrib Nephrol. 2010;166:73-82. doi: 10.1159/000314855. Epub 2010 May 7.
4
Posterior reversible encephalopathy syndrome: associated clinical and radiologic findings.后部可逆性脑病综合征:相关临床和影像学表现。
Mayo Clin Proc. 2010 May;85(5):427-32. doi: 10.4065/mcp.2009.0590.
5
Hypercytokinemia-induced metabolic encephalopathy in a multiple myeloma patient on hemodialysis undergoing autologous stem cell transplantation: clinical response after plasma exchange.血液透析多发性骨髓瘤自体干细胞移植患者细胞因子血症相关代谢性脑病:血浆置换后的临床疗效
Transpl Immunol. 2009 Sep;21(4):240-3. doi: 10.1016/j.trim.2009.06.002. Epub 2009 Jun 16.
6
Neurological complications of hematopoietic stem cell transplantation (HSCT): a retrospective study in a HSCT center in Brazil.造血干细胞移植(HSCT)的神经并发症:巴西一家HSCT中心的回顾性研究。
Arq Neuropsiquiatr. 2008 Sep;66(3B):685-90. doi: 10.1590/s0004-282x2008000500014.
7
Central nervous system complications after allogeneic hematopoietic stem cell transplantation: incidence, manifestations, and clinical significance.异基因造血干细胞移植后的中枢神经系统并发症:发生率、表现及临床意义。
Biol Blood Marrow Transplant. 2007 Nov;13(11):1369-79. doi: 10.1016/j.bbmt.2007.07.013. Epub 2007 Sep 21.
8
TNF is a key mediator of septic encephalopathy acting through its receptor, TNF receptor-1.肿瘤坏死因子(TNF)是脓毒症脑病的关键介质,通过其受体肿瘤坏死因子受体-1发挥作用。
Neurochem Int. 2008 Feb;52(3):447-56. doi: 10.1016/j.neuint.2007.08.006. Epub 2007 Aug 17.
9
Continuous hemodiafiltration with cytokine-adsorbing hemofilter in the treatment of severe sepsis and septic shock.采用细胞因子吸附血液滤过器进行连续性血液透析滤过治疗严重脓毒症和脓毒性休克。
Contrib Nephrol. 2007;156:365-70. doi: 10.1159/000102127.
10
Spectrum and prognosis of neurologic complications after hematopoietic transplantation.造血移植后神经系统并发症的谱系和预后
Neurology. 2006 Dec 12;67(11):1990-7. doi: 10.1212/01.wnl.0000247038.43228.17.

美法仑是自体造血干细胞移植期间急性脑病的罪魁祸首还是混淆因素?

Melphalan Culprit or Confounder in Acute Encephalopathy during Autologous Hematopoietic Stem Cell Transplantation?

作者信息

Alayón-Laguer Diógenes, Alsina Melissa, Ochoa-Bayona Jose L, Ayala Ernesto

机构信息

Hematology-Oncology Program San Juan City Hospital and VA Caribbean Healthcare System, 10 Calle Casia, San Juan, PR 00921, USA.

出版信息

Case Rep Transplant. 2012;2012:942795. doi: 10.1155/2012/942795. Epub 2012 May 7.

DOI:10.1155/2012/942795
PMID:23259145
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3505956/
Abstract

We report a case of a female patient with Durie-Salmon stage 3A/ISS stage I IgG kappa multiple myeloma (MM) who developed encephalopathy after high-dose melphalan and hematopoietic stem cell transplant (HSCT). The most common etiologies for encephalopathy such as infection, narcotic medications, metabolic-electrolyte disturbance, stroke, and central nervous system (CNS) hemorrhages were ruled out. The patient recovered from the altered mental status spontaneously. The possibilities of melphalan-induced encephalopathy versus critical-state delirium versus hypercytokinemia induce encephalopathy were contemplated.

摘要

我们报告了一例Durie-Salmon 3A期/国际分期系统(ISS)I期IgG κ型多发性骨髓瘤(MM)女性患者,其在接受大剂量美法仑和造血干细胞移植(HSCT)后发生了脑病。脑病最常见的病因,如感染、麻醉药物、代谢电解质紊乱、中风和中枢神经系统(CNS)出血,均被排除。患者的精神状态改变自行恢复。我们考虑了美法仑诱发的脑病、危重症谵妄与高细胞因子血症诱发脑病的可能性。