Summary:Adenoviruses are increasingly realised to be responsible for serious morbidity and mortality following allogeneic bone marrow transplantation. We describe a case of fulminant hepatic failure due to adenovirus serotype 2 in a 39-year-old woman who received a matched sibling allogeneic bone marrow transplant for multiply relapsed Hodgkin's disease. Isolated fulminant hepatic failure caused by this serotype of adenovirus has not previously been described. Keywords: adenovirus; hepatic failure; bone marrow transplant Case reportA 35-year-old woman presented with bulky stage IIA nodular sclerosing Hodgkin's disease involving the mediastinum. She received three full cycles of ChlVPP/ PABLOE 1 and mantle radiotherapy to the residual mass. She relapsed 2 years later in the anterior mediastinum and received mini-BEAM 2 as salvage chemotherapy. She was primed with cyclophosphamide for stem cell collection and then received high-dose therapy with stem cell rescue 3 ). The procedure was uncomplicated. Within 6 months she relapsed once more, this time with disease extending from the mediastinum into the lung parenchyma. A regimen of weekly vinca alkaloid injections prevented clinical and radiological deterioration for 11 months but then her disease progressed again. Two courses of ESHAP (without methylprednisolone) 4 were given as bulk reduction treatment before a sibling allogeneic bone marrow transplant. The conditioning regimen was Campath 1-G (20 mg daily from days −9 to −5), thiotepa (5 mg/kg on days −8 and −7), cyclophosphamide (60 mg/kg on days −6 and −5) and total body irradiation (14.4 Gy in 8 fractions from days −4 to 0). The graft was T cell depleted and the recipient was CMV positive. The transplant was uncomplicated and she was discharged on day 21. A month later she was read-
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