2020 年 46 巻 10 号 p. 593-599
We experienced the administration of chemotherapy to a hemophilia patient with testicular tumors. The patient in this case was a man who was approximately 40 years old. He was being treated under a regimen with factor VIII replenishment prophylactic therapy for Type A hemophilia at our hospital. In January 20XX, this patient was referred to our urology department, complaining of a swollen scrotum, and was diagnosed with a right testicular tumor. A right high orchiectomy was performed in February of the same year. In April of the same year, a Computed Tomography confirmed liver metastasis, and BEP therapy was started as a treatment for postoperative recurrence. During the anticancer treatment, the dosage of the regular supplementation of the freeze-dried concentrated human blood coagulation factor VIII preparations was increased to 1000 units three times per week. If bleeding symptoms associated with hemophilia were found to be confirmed, then a single additional intravenous dose of 1,000 units was administered. We continuously monitored the bleeding symptoms and regularly examined the levels of platelets and APTT, the activation of coagulation factors, levels of hemoglobin, and possible skin-associated symptoms in the patient. If APTT was found to be prolonged for more than 35 s beyond the upper limit of the normal APTT duration, the additional freeze-dried concentrated human blood coagulation factor VIII preparation was administered. As a result, we were able to complete a total of four courses of the BEP therapy without observation of major bleeding in the patient.
