Nishii Kazuhiro, Mitani Hidetsugu, Miyashita Hiroyuki, Hoshino Natsuki, Usui Eiji, Sakakura Miho, Nishikawa Hiroyoshi, Katayama Naoyuki, Kobayashi Tohru, Shiku Hiroshi
Second Department of Internal Medicine, Mie University School of Medicine.
Rinsho Ketsueki. 2002 Mar;43(3):189-93.
A 52-year-old man was admitted for treatment of hypoplastic leukemia (M 1). After induction chemotherapy with IDR and AraC, the patient developed prolonged febrile neutropenia, and a diagnosis of invasive pulmonary aspergillosis was made. We started administration of AMPH-B and G-CSF, but the patient showed no clinical improvement. M-CSF was added to the regimen, and this led to an increase in the white blood cell count with resolution of pneumonia. It is suggested that administration of M-CSF with antibiotics and G-CSF may be beneficial for treating acute leukemia patients with prolonged febrile neutropenia after intensive chemotherapy.
一名52岁男性因低增生性白血病（M1型）入院治疗。在接受伊达比星（IDR）和阿糖胞苷（AraC）诱导化疗后，患者出现长时间发热性中性粒细胞减少，诊断为侵袭性肺曲霉病。我们开始给予两性霉素B（AMPH - B）和粒细胞集落刺激因子（G - CSF），但患者临床症状无改善。随后在治疗方案中加入巨噬细胞集落刺激因子（M - CSF），这使得白细胞计数增加，肺炎得到缓解。提示在强化化疗后出现长时间发热性中性粒细胞减少的急性白血病患者中，联合使用M - CSF、抗生素和G - CSF可能有益。
