Abstract
A 15-year-old boy had Burkitt lymphoma complicated by portal vein thrombosis (PVT) after unrelated-donor bone marrow transplantation (u-BMT). He presented with right cervical tumor, and pathological examination revealed Burkitt lymphoma. Although he was initially treated with irradiation and chemotherapy, his disease relapsed about 9 months after starting treatment. He received u-BMT after conditioning with total body irradiation, etoposide, and ifosfamide. On day 24, fibrinogen degradation products (FDP) and D-dimer in plasma were increased, so ultrasound examination was performed to screen for thrombus. A high-echogenic region was detected in the portal vein, and PVT was diagnosed by computed tomography (CT). At that time, plasma protein C and antithrombin III were not decreased, and thrombomodulin was slightly increased. He was treated with urokinase and heparin, and CT on day 55 showed no thrombus in the portal vein. The complication of PVT after stem cell transplantation (SCT) is rare, and an ultrasound examination is useful for diagnosing PVT. We speculate that the cause of PVT may be the existence of a hypercoagulable state and endothelial damage after SCT.
