Successful control of massive gastrointestinal bleeding following umbilical cord blood transplantation (UCBT) by use of recombinant activated factor VII (rFVIIa) and octreotide infusion

Pediatric Hematology and Oncology
Satya Prakash YadavSatyendra Katewa

Abstract

Post hematopoietic stem cell transplantation (HSCT) gastrointestinal (GI) bleeding is a dreaded complication. There are only five other reports (one randomised trial and four case reports) of use of rFVIIa for massive lower GI bleeding post-allogeneic HSCT. In only one publication, two adult patients showed complete response. Eroglu has reported a response rate of 50% to octreotide in gastrointestinal bleeding in patients without portal hypertension. We present a 10 month-old female child, who had three episodes of life threatening lower GI bleeding post unrelated Umbilical Stem Cell Transplant (UCBT) controlled successfully each time by use of rFVIIa and octreotide infusion and review of literature. To our knowledge this is the first and youngest case reported, in which both rFVIIa and octreotide have been used successfully to control life threatening lower GI bleeding post UCBT.

References

Dec 10, 1999·Lancet·G KenetU Martinowitz
Dec 17, 2003·Journal of Pediatric Gastroenterology and Nutrition·Y ErogluE M Alonso
Apr 7, 2005·Haemophilia : the Official Journal of the World Federation of Hemophilia·C G MillarM Richards
Aug 17, 2005·Journal of Thrombosis and Haemostasis : JTH·M PihuschUNKNOWN F7BMT-1360 Trial Investigators
Dec 2, 2008·Journal of Pediatric Surgery·Howard Jen, Stephen Shew

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Citations

Feb 18, 2011·Indian Journal of Pediatrics·Sunil BhatAnupam Sachdeva
May 11, 2013·Indian Journal of Pediatrics·Ankur Bahl, Sameer Bakhshi
Apr 26, 2013·Pediatric Hematology and Oncology·Satya Prakash Yadav, Anupam Sachdeva
Jul 22, 2016·Transfusion Medicine Reviews·Jennifer Webb, Allistair Abraham

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