Dramatic Response to Systemic Bevacizumab Therapy in a Patient with Hereditary Hemorrhagic Telangiectasia
Öz
Hereditary hemorrhagic telangiectasia is a rare multisystem vascular disorder. Also known as Rendu Osler syndrome, it is characterized by mucocutaneous telangiectases, epistaxis, gastrointestinal bleeding, and visceral arteriovenous malformations. A sixty-two-year old male patient was followed due to hereditary hemorrhagic telangiectasia. Because of high transfusion dependency he received bevacizumab administration at a dose of 5 mg/kg every 2 weeks, for a total of eight cycles. We achieved considerable response in terms of the dependency of transfusion after bevacizumab treatment. Serum and tissue expression of vascular endothelial growth factor is increased in patients with hereditary hemorrhagic telangiectasia. Thus, logically, vascular endothelial growth factor inhibitors could be expected to function in the therapy of hereditary hemorrhagic telangiectasia as well.
Anahtar Kelimeler
Kaynakça
- Kanellopoulou T, Alexopoulou A. Bevacizumab in the treatment of hereditary hemorrhagic telangiectasia. Expert Opin Biol Ther 2013;13(9):1315-23.
- Geisthoff UW, Schneider G, Fischinger J, Plinkert PK. Hereditary hemorrhagic telangiectasia. HNO 2002;50:114-28.
- Carmeliet P, Jain RK. Angiogenesis in cancer and other diseases. Nature 2000;407:249-57.
- Lupu A, Stefanescu C, Treton X, Attar A, Corcos O, Bouhnik Y. Bevacizumab as rescue treatment for severe recurrent gastrointestinal bleeding in hereditary hemorrhagic telangiectasia. J Clin Gastroenterol 2013;47:256-7.
- Carmeliet P. Angiogenesis in life; disease and medicine. Nature 2005;438:932-6.
- Hurwitz H, Fehrenbacher L, Novotny W, Cartwright T, Hainsworth J, Heim W et al. Bevacizumab plus irinotecan, flurouracil and leucovorin for metastatic colorectal cancer. N Engl J Med 2004;350:2335-42.
- Sandler A, Gray R, Perry MC, Brahmer J, Schiller JH, Dowlati A et al. Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med 2006;355(24):2542-50.
- Michels S, Rosenfeld PJ, Puliafito CA, Marcus EN, Venkatraman AS. Systemic bevacizumab therapy for neovascular age-related macular degeneration: twelve-week results of an uncontrolled open-label clinical study. Opthalmology 2005;112:1035-47.
- Sadick H, Naim R, Gossler U, Hormann K, Reidel F. Angiogenesis in hereditary hemorrhagic telangiectasia: VEGF165 plasma concentration in correlation to the VEGF expression and microvessel density. Int J Mol Med 2005;15:15-9.
- Flieger D, Hainke S, Fischbach W. Dramatic improvement in hereditary hemorrhagic telangiectasia after treatment with vascular endothelial growth factor (VEGF) antagonist bevacizumab. Ann Hematol 2006;85:631-2.
- Rohrmeier C, Kühnel TS. Bevazicumab in therapy-refractory epistaxis. Case report of low-dose antibody therapy for hereditary hemorrhagic telangiectasia. HNO 2012;60(11):1003-6.
- Dupuis-Girod S, Ginon I, Saurin JS, Marion D, Guillot E, Decullier E et al. Bevacizumab in patients with hereditary hemorrhagic telangiectasia and severe hepatic vascular malformations and hight cardiac output. JAMA 2012;307:948-55.
- Shord SS, Bressler LR, Tierney LA, Cuellar S, George A. Understanding and managing the possible adverse effects associated with bevacizumab. Am J Health Syst Pharm 2009;66(11):999-1003.
- Üyetürk Ü, Öksüzoğlu B, Yalçıntaş Arslan Ü, Alkış N. Metastatik kolon kanseri tedavisinde bevacizumab kullanımına bağlı ince barsak perforasyonu gelişen bir olgu ve literatürün gözden geçirilmesi. Turkish Journal of Oncology 2011;26(4):178-81.
Öz
Herediter hemorajik telenjiektazi nadir görülen multisistemik vasküler bir hastalıktır. Rendu Osler sendromu olarak da bilinmekle birlikte mukokutanöz telenjiektaziler, epistaksis, gastrointestinal kanamalar ve viseral arteriovenöz malformasyonlarla karakterizedir. Altmış iki yaşında erkek hasta; herediter hemorajik telenjiektazi tanısıyla takip edilmektedir. Yoğun transfüzyon ihtiyacı olması nedeniyle hastaya bevacizumab 5mg/kg dozunda 2 haftada bir olmak üzere toplam 8 kür uygulanması sonrası transfüzyon ihtiyacında dramatik azalma görülmüştür. Herediter hemorajik telenjiektazi hastalarının serum ve dokuda bakılan vasküler endotelyal büyüme faktörü düzeylerinin artmış olduğu gösterilmiştir. Bu bağlamda vasküler endotelyal büyüme faktörü inhibitörlerinin bu hastalarda etkili olacağı düşünülmektedir.
Anahtar Kelimeler
Kaynakça
- Kanellopoulou T, Alexopoulou A. Bevacizumab in the treatment of hereditary hemorrhagic telangiectasia. Expert Opin Biol Ther 2013;13(9):1315-23.
- Geisthoff UW, Schneider G, Fischinger J, Plinkert PK. Hereditary hemorrhagic telangiectasia. HNO 2002;50:114-28.
- Carmeliet P, Jain RK. Angiogenesis in cancer and other diseases. Nature 2000;407:249-57.
- Lupu A, Stefanescu C, Treton X, Attar A, Corcos O, Bouhnik Y. Bevacizumab as rescue treatment for severe recurrent gastrointestinal bleeding in hereditary hemorrhagic telangiectasia. J Clin Gastroenterol 2013;47:256-7.
- Carmeliet P. Angiogenesis in life; disease and medicine. Nature 2005;438:932-6.
- Hurwitz H, Fehrenbacher L, Novotny W, Cartwright T, Hainsworth J, Heim W et al. Bevacizumab plus irinotecan, flurouracil and leucovorin for metastatic colorectal cancer. N Engl J Med 2004;350:2335-42.
- Sandler A, Gray R, Perry MC, Brahmer J, Schiller JH, Dowlati A et al. Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med 2006;355(24):2542-50.
- Michels S, Rosenfeld PJ, Puliafito CA, Marcus EN, Venkatraman AS. Systemic bevacizumab therapy for neovascular age-related macular degeneration: twelve-week results of an uncontrolled open-label clinical study. Opthalmology 2005;112:1035-47.
- Sadick H, Naim R, Gossler U, Hormann K, Reidel F. Angiogenesis in hereditary hemorrhagic telangiectasia: VEGF165 plasma concentration in correlation to the VEGF expression and microvessel density. Int J Mol Med 2005;15:15-9.
- Flieger D, Hainke S, Fischbach W. Dramatic improvement in hereditary hemorrhagic telangiectasia after treatment with vascular endothelial growth factor (VEGF) antagonist bevacizumab. Ann Hematol 2006;85:631-2.
- Rohrmeier C, Kühnel TS. Bevazicumab in therapy-refractory epistaxis. Case report of low-dose antibody therapy for hereditary hemorrhagic telangiectasia. HNO 2012;60(11):1003-6.
- Dupuis-Girod S, Ginon I, Saurin JS, Marion D, Guillot E, Decullier E et al. Bevacizumab in patients with hereditary hemorrhagic telangiectasia and severe hepatic vascular malformations and hight cardiac output. JAMA 2012;307:948-55.
- Shord SS, Bressler LR, Tierney LA, Cuellar S, George A. Understanding and managing the possible adverse effects associated with bevacizumab. Am J Health Syst Pharm 2009;66(11):999-1003.
- Üyetürk Ü, Öksüzoğlu B, Yalçıntaş Arslan Ü, Alkış N. Metastatik kolon kanseri tedavisinde bevacizumab kullanımına bağlı ince barsak perforasyonu gelişen bir olgu ve literatürün gözden geçirilmesi. Turkish Journal of Oncology 2011;26(4):178-81.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 15 Aralık 2015 |
| Yayımlandığı Sayı | Yıl 2015 Cilt: 22 Sayı: 4 |
