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Gestational trophoblastic neoplasia treated with low-dose induction chemotherapy despite prognostic score < 13: a
Patrick Marta1, Katelyn B Furey2, Hadi Erfani2
1Harbor-UCLA Medical Center, 1000 W Carson St, Torrance, CA 90502, United States of America.
Background:
Gestational trophoblastic neoplasia (GTN) can cause significant morbidity and mortality if not appropriately recognized and treated. Low-dose induction chemotherapy is recommended for "ultra-high risk" GTN- defined as prognostic score ≥ 13 - to prevent mortality from hemorrhage that occurs when tumors respond rapidly.
Case:
A 22-year-old patient presented with hemoptysis due to pulmonary metastases from GTN, but with WHO score < 13. A multi-disciplinary care team began treatment with low-dose induction chemotherapy to prevent worsening pulmonary hemorrhage. While she required intubation to complete induction chemotherapy, she did not suffer further pulmonary hemorrhage during treatment.
Conclusion:
Low-dose induction chemotherapy should be considered as treatment for patients with GTN and pulmonary metastasis causing hemorrhage even if WHO score is <13.
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