Long-term survival of a pediatric hematopoietic cell transplant recipient with Fanconi anemia treated with extracorporeal membrane oxygenation: Case report and review of the literature

Abstract

Background: Pediatric hematopoietic cell transplant (HCT) patients treated with extracorporeal membrane oxygenation (ECMO) have historically experienced poor outcomes. Recent survey data indicates that critical care providers are more open to offering ECMO therapy to pediatric HCT patients. Recent data has also shown improved survival in this patient population. However, data regarding the use of ECMO in nonmalignant conditions is limited. Case report: We present the first successful use of ECMO for a child with Fanconi anemia. A 5-year-old girl with VACTERL sequence, repaired complex congenital heart disease, and multiple complex medical comorbidities developed respiratory failure after a matched unrelated CD34 selected peripheral blood HCT. The patient was treated with steroids and etanercept and received 8 days of ECMO support. She is now 6 years post-HCT and doing well. Conclusion: We highlight this case due to our patient's high medical complexity and positive long-term outcomes after using ECMO.

Keywords

• Hematopoietic stem cell transplant
• Pediatric
• Fanconi
• Bone marrow failure
• Extracorporeal membrane oxygenation
• Etanercept