Nakaoka Hajime, Sakata Yasushi, Yamamoto Masaki, Maeda Tetsuo, Arita Yoh, Shioyama Wataru, Nakaoka Yoshikazu, Kanakura Yuzuru, Yamashita Shizuya, Komuro Issei, Yamauchi-Takihara Keiko
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
J Cardiol Cases. 2010 Feb 19;2(1):e23-e27. doi: 10.1016/j.jccase.2010.01.008. eCollection 2010 Aug.
Bone marrow transplantation (BMT) is one of the promising methods of treatment of hematologic malignancy. However, it has a variety of complications since it involves fatal doses of anti-cancer drugs and radiation during the conditioning period. Among the various complications of BMT, pulmonary hypertension is rare and its pathogenesis is poorly understood. A 35-year-old female with acute myeloid leukemia (AML) presented with pulmonary hypertension after BMT. Although she exhibited severe dyspnea on admission, her general condition markedly improved after oxygen therapy and treatment with warfarin and beraprost sodium. Her pulmonary hypertension was diagnosed as pulmonary arterial hypertension (PAH) related to BMT. Although PAH has only rarely been reported as a complication of BMT, we present here for the first time an adult patient with PAH associated with BMT who exhibited marked improvement with medical treatment. This case indicates that attention needs to be paid to the clinical symptoms and physical findings of PAH as a complication of BMT.
骨髓移植（BMT）是治疗血液系统恶性肿瘤的一种有前景的方法。然而，由于在预处理期涉及致死剂量的抗癌药物和辐射，它会引发多种并发症。在BMT的各种并发症中，肺动脉高压较为罕见，其发病机制也知之甚少。一名35岁的急性髓系白血病（AML）女性在BMT后出现了肺动脉高压。尽管她入院时表现出严重呼吸困难，但经氧疗以及使用华法林和贝拉普唑钠治疗后，她的一般状况明显改善。她的肺动脉高压被诊断为与BMT相关的肺动脉高压（PAH）。虽然PAH作为BMT的并发症仅有极少报道，但我们在此首次呈现了一名成年PAH患者，其与BMT相关，经药物治疗后有显著改善。该病例表明，作为BMT并发症的PAH的临床症状和体征需要引起关注。
