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MİYELODİSPLASTİK SENDROMDA TALİDOMİD KULLANIMINA BAĞLI VENÖZ TROMBOEMBOLİZM: OLGU SUNUMU

Yıl 2016, Cilt: 30 Sayı: 3, 187 - 190, 01.12.2016

Öz

Talidomid Multipl Miyelom ve düşük risk miyelodisplastik sendrom tedavisinde kullanılan immünmodülatör bir ajan olup, Venöz Tromboemboli riskini arttırmaktadır. Olgumuz 77 yaşında kadın hasta olup, 2 yıldır düşük risk Miyelodisplastik Sendrom tanısı ile Talidomid kullanmaktaydı. Ani başlayan dispne ve göğüs ağrısı sonrası çekilen Toraks Bilgisayarlı Tomografide sağ ana pulmoner arter ile sol üst ve alt lob arter dallarında trombüs, alt ekstremite venöz doppler ultrasonogrofide ise bilateral akutsubakut derin ven trombüs saptandı. B-tip Natriüretik peptid (BNP), Troponin normal olup, ekokardiyografide sağ ventrikül disfonksiyonunu gösteren patoloji saptanmadı. Düşük mortalite riskli Pulmoner Tromboemboli kabul edilen hastaya enoksaparin ve oral warfarin tedavisi verilerek taburcu edildi. Talidomid tedavisi kesildi. Bu yazıda Talidomid kullanımına bağlı gelişen ve nadir görülen Venöz Tromboembolizm vakası sunulmuştur.

Kaynakça

  • 1. Türk Toraks Derneği Pulmoner Tromboembolizm Tanı ve Uzlaşı Raporu; 2015.
  • 2. Prommer EE, Twycross R, Mihalyo M, Wilcock A. Thalidomide. Journal of Pain and Symptom Management. 2011; 41(1): 140-5.
  • 3. Palumbo A, Palladino C. Venous and arterial thrombotic risks with thalidomide: evidence and practical guidance. Therapeutic Advances in Drug Safety 2012; 3(5): 255 –66.
  • 4. Tefferi A, Vardiman JW. Mechanısms of Disease - Myelodysplastic Syndromes. N Engl J Med 2009; 361: 1872-85.
  • 5. Chung CY, Lın SF, Chen PM, Chang MC, Kao WY, Chao TY, et al. Thalidomide for the Treatment of Myelodysplastic Syndrome in Taiwan: Results of a Phase II Trial. Anticancer research 2012; 32: 3415-20.
  • 6. Zangari M, Anaissie E, Barlogie B, Badros A, Desikan R, Gopal AV, et al. Increased risk of deep-vein thrombosis in patients with multiple myeloma receiving thalidomide and chemotherapy. Blood 2001; 98(5): 1614-5.
  • 7. Bennett CL, Nebeker JR, Lyons AE.Samore MH, Feldman MD, McKoy JM, et al. The Research on Adverse Drug Events and Reports (RADAR) Project. JAMA 2005; 293: 2131-40.
  • 8. Ahamed R, Bandula W, Chamara R. An unexpected case of venous and pulmonary thrombo-embolism in a patient treated with thalidomide for refractory erythema nodosum leprosum: a case report. Thrombosis Journal 2011; 9: 1-4.
  • 9. Lyman GH, Khorana AA, Falanga A, ClarkePearson D, Flowers C, Jahanzeb M, et al. American Society of Clinical Oncology guideline: Recommendations for venous thromboembolism prophylaxis and treatment in patients with cancer. J Clin Oncol 2007; 25(34): 5490-505.
  • 10. Kovacs MJ, Davies GA, Chapman JA, Bahlis N, Voralia M, Roy J, et al. Thalidomide-prednisone maintenance following autologous stem cell transplant for multiple myeloma: effect on thrombin generation and procoagulant markers in NCIC CTG MY.10. Br Haematol 2015; 168(4): 511-7.

VENOUS THROMBOEMBOLISM DUE TO THE USE OF THALIDOMIDE IN MYELODYSPLASTIC SYNDROME: CASE REPORT

Yıl 2016, Cilt: 30 Sayı: 3, 187 - 190, 01.12.2016

Öz

Thalidomide is an immunomodulatory agent used in the treatment of multiple myeloma and low risk myelodysplastic syndrome and it has an increasing affect for venous thromboembolism. Our case is a 77 year old female patient who was using thalidomide for 2 years with the diagnosis of low-risk myelodysplastic syndrome. Chest computed tomography done after sudden onset of dyspnea and chest pain determined thrombus in the right main pulmonary artery and in the left upper and lower lobe pulmonary arteries and venous doppler ultrasonography revealed acute and sub-acute deep vein thrombosis in bilateral lower extremity. B-type natriuretic peptide (BNP) and troponin were normal. Echocardiography did not show any right ventricular dysfunction pathology. Patient who was accepted as ‘Pulmonary Thromboembolism with low mortality risk' was given enoxaparin and oral warfarin therapy. Thalidomide therapy was stopped. In this paper a rare case of venous thromboembolism due to the use of thalidomide is reported.

Kaynakça

  • 1. Türk Toraks Derneği Pulmoner Tromboembolizm Tanı ve Uzlaşı Raporu; 2015.
  • 2. Prommer EE, Twycross R, Mihalyo M, Wilcock A. Thalidomide. Journal of Pain and Symptom Management. 2011; 41(1): 140-5.
  • 3. Palumbo A, Palladino C. Venous and arterial thrombotic risks with thalidomide: evidence and practical guidance. Therapeutic Advances in Drug Safety 2012; 3(5): 255 –66.
  • 4. Tefferi A, Vardiman JW. Mechanısms of Disease - Myelodysplastic Syndromes. N Engl J Med 2009; 361: 1872-85.
  • 5. Chung CY, Lın SF, Chen PM, Chang MC, Kao WY, Chao TY, et al. Thalidomide for the Treatment of Myelodysplastic Syndrome in Taiwan: Results of a Phase II Trial. Anticancer research 2012; 32: 3415-20.
  • 6. Zangari M, Anaissie E, Barlogie B, Badros A, Desikan R, Gopal AV, et al. Increased risk of deep-vein thrombosis in patients with multiple myeloma receiving thalidomide and chemotherapy. Blood 2001; 98(5): 1614-5.
  • 7. Bennett CL, Nebeker JR, Lyons AE.Samore MH, Feldman MD, McKoy JM, et al. The Research on Adverse Drug Events and Reports (RADAR) Project. JAMA 2005; 293: 2131-40.
  • 8. Ahamed R, Bandula W, Chamara R. An unexpected case of venous and pulmonary thrombo-embolism in a patient treated with thalidomide for refractory erythema nodosum leprosum: a case report. Thrombosis Journal 2011; 9: 1-4.
  • 9. Lyman GH, Khorana AA, Falanga A, ClarkePearson D, Flowers C, Jahanzeb M, et al. American Society of Clinical Oncology guideline: Recommendations for venous thromboembolism prophylaxis and treatment in patients with cancer. J Clin Oncol 2007; 25(34): 5490-505.
  • 10. Kovacs MJ, Davies GA, Chapman JA, Bahlis N, Voralia M, Roy J, et al. Thalidomide-prednisone maintenance following autologous stem cell transplant for multiple myeloma: effect on thrombin generation and procoagulant markers in NCIC CTG MY.10. Br Haematol 2015; 168(4): 511-7.
Toplam 10 adet kaynakça vardır.

Ayrıntılar

Diğer ID JA47RJ63PK
Bölüm Olgu Sunumu
Yazarlar

Şule Taş Gülen Bu kişi benim

İrfan Yavaşoğlu Bu kişi benim

Yayımlanma Tarihi 1 Aralık 2016
Yayımlandığı Sayı Yıl 2016 Cilt: 30 Sayı: 3

Kaynak Göster

APA Gülen, Ş. T., & Yavaşoğlu, İ. (2016). MİYELODİSPLASTİK SENDROMDA TALİDOMİD KULLANIMINA BAĞLI VENÖZ TROMBOEMBOLİZM: OLGU SUNUMU. İzmir Göğüs Hastanesi Dergisi, 30(3), 187-190.