nodgoРоссийский журнал детской гематологии и онкологии (РЖДГиО)Russian Journal of Pediatric Hematology and Oncology2311-12672413-5496LTD “Graphica”10.17650/2311-1267-2016-3-3-61-65nodgo-249Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL CASESСлучай успешной терапии ритуксимабом вторичного гемолитико- уремического синдрома у пациента после повторной аллогенной трансплантации гемопоэтических стволовых клетокThe case of successful therapy with rituximab secondary hemolytic-uremic syndrome in a patient after the second allogeneic hematopoietic stem cell transplantationПристансковаЕ. А.PristanskovaE. A.

117997, Москва, Ленинский просп., 117

117 Leninskiy Prosp., Moscow, 117997

eprist82@mail.ruКиргизовК. И.KirgizovK. I.

117997, Москва, Ленинский просп., 117;

117997, Москва, ул. Саморы Машела, 1

117 Leninskiy Prosp., Moscow, 117997;

1 Samory Mashela St., Moscow, 117997

СидороваН. В.SidorovaN. V.

117997, Москва, Ленинский просп., 117

117 Leninskiy Prosp., Moscow, 117997

КонстантиноваВ. В.KonstantinovaV. V.

117997, Москва, Ленинский просп., 117

117 Leninskiy Prosp., Moscow, 117997

БуряА. Е.BuryaA. E.

117997, Москва, Ленинский просп., 117

117 Leninskiy Prosp., Moscow, 117997

СкоробогатоваЕ. В.SkorobogatovaE. V.

117997, Москва, Ленинский просп., 117

117 Leninskiy Prosp., Moscow, 117997

ФГБУ «Российская детская клиническая больница» Минздрава РоссииРоссияRussian Children's Clinical Hospital, Ministry of Health of RussiaRussian FederationФГБУ «Российская детская клиническая больница» Минздрава России; ФГБУ «ФНКЦ ДГОИ им. Дмитрия Рогачева» Минздрава РоссииРоссияRussian Children's Clinical Hospital, Ministry of Health of Russia; Federal Research Center of Pediatric Hematology, Oncology and Immunology named after Dmitriy Rogachev, Ministry of Health of RussiaRussian Federation201622092016336165Copyright © Пристанскова Е.А., Киргизов К.И., Сидорова Н.В., Константинова В.В., Буря А.Е., Скоробогатова Е.В., 20162016Пристанскова Е.А., Киргизов К.И., Сидорова Н.В., Константинова В.В., Буря А.Е., Скоробогатова Е.В.Pristanskova E.A., Kirgizov K.I., Sidorova N.V., Konstantinova V.V., Burya A.E., Skorobogatova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nodgo.org/jour/article/view/249

Трансплантат-ассоциированная тромботическая микроангиопатия (ТА-ТМА) является редким, но крайне неблагоприятным мультифакториальным осложнением аллогенной трансплантации гемопоэтических стволовых клеток (ТГСК). Затрудняют диагностику ТА-ТМА неспецифичность клинических признаков и гистологической картины, а также частое ее возникновение на фоне других осложнений ТГСК. В настоящее время не существует четких рекомендаций по лечению ТА-ТМА. В данной работе представлен клинический случай манифестации ТА-ТМА в виде гемолитико-уремического синдрома у пациента с 4-й ремиссией острого лимфобластного лейкоза на ранних сроках после повторной аллогенной ТГСК. Показана возможность успешной терапии с помощью препарата ритуксимаб со стабилизацией состояния и разрешением ТА-ТМА.

Transplant-associated thrombotic microangiopathy (TA-TMA) is rare but very unfavour multifactorial complication of allogenic hematopoietic stem cell transplantation (HSCT). Diagnostics of TA-TMA complicated by non-specificity of clinical signs and histological picture, as well as its frequent appearance in the background of other complications of HSCT. Currently there are no clear recommendations for TA-TMA treatment. This clinical case demonstrates manifestation of TA-TMA as hemolytic-uremic syndrome at the patient in 4th remission of acute lymphoblastic leukemia on the early stages after the second allogenic HSCT. Possibility of successful rituximab therapy with condition stabilization and TA-TMA resolving demonstrated.

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The authors declare that there are no conflicts of interest present.