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(Chest. 2003;124:2400-2403.)
© 2003 American College of Chest Physicians

Diffuse Alveolar Hemorrhage After Allogeneic Hematopoietic Stem-Cell Transplantation*

Treatment With Recombinant Factor VIIa

Stephen M. Pastores, MD, FCCP; Esperanza Papadopoulos, MD; Louis Voigt, MD and Neil A. Halpern, MD, FCCP

* From the Department of Anesthesiology and Critical Care Medicine (Drs. Pastores, Voigt, and Halpern), and Adult Bone Marrow Transplantation Service (Dr. Papadopoulos), Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY.

Correspondence to: Stephen M. Pastores, MD, FCCP, Associate Attending, Department of Anesthesiology and Critical Care Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Ave M-210, New York, NY 10021; e-mail: pastores{at}mskcc.org

Diffuse alveolar hemorrhage (DAH) is a serious pulmonary complication that occurs in patients undergoing hematopoietic stem-cell transplantation (HSCT). Current management strategies are limited to corticosteroids, platelet transfusions, and mechanical ventilator support to treat acute respiratory failure. Recombinant factor VIIa (rFVIIa) is an approved agent for the treatment of bleeding in patients with hemophilia A or B and the presence of inhibitors. We report a case of DAH after allogeneic HSCT that failed standard therapy and was then successfully treated with rFVIIa.

Key Words: allogeneic hematopoietic stem-cell transplantation • diffuse alveolar hemorrhage • recombinant factor VIIa




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