造血器悪性腫瘍の分子標的治療薬投与中に多臓器不全を来した2症例

Two Cases of Tumor Lysis Syndrome, Infusion Reaction and Differentiation Syndrome, during Molecular-targeted Therapy for Hematologic Tumors

要旨

　造血器悪性腫瘍に対して分子標的治療薬を投与し，infusion reactionと腫瘍崩壊症候群を来した1症例と，分化症候群を来した1症例を集中治療室で管理した。分子標的治療薬の開発で治療成績は大幅に向上した。しかし，その投与により致死的有害事象が発症することがあるため，その予防と集中治療管理が重要と考えられた。

　We report a case of infusion reaction and tumor lysis syndrome and another case of acute promyelocytic leukemia（APL）differentiation syndrome；both of these complications were due to the patients’ adverse reactions to molecular-targeted therapy for hematologic tumors. Both patients developed multiple organ failure and were managed in our hospital’s intensive care unit. Although molecular-targeted therapies have greatly improved patient outcomes in recent years, they also have unique side-effect profiles. The severe adverse reactions experienced by the present two patients are not frequent but may be fatal without appropriate intensive-care interventions.