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急性髓系白血病合并肺和脑毛霉菌病的干细胞移植

Stem cell transplantation for acute myeloid leukemia with pulmonary and cerebral mucormycosis.

作者信息

Suzuki Daisuke, Kobayashi Ryoji, Hori Daiki, Kishimoto Kenji, Sano Hirozumi, Yasuda Kazue, Kobayashi Kunihiko

机构信息

Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Hokkaido, Japan.

出版信息

Pediatr Int. 2016 Jul;58(7):569-72. doi: 10.1111/ped.12866. Epub 2016 Feb 19.

Abstract

BACKGROUND

Mucormycosis is one of the most refractory invasive fungal infections and often causes fatal infection in immunocompromised patients, such as those with severe diabetes mellitus and hematologic malignancies.

METHODS

We retrospectively evaluated the efficacy of stem cell transplantation for a pediatric patient with refractory acute myeloid leukemia (AML) who developed mucormycosis.

RESULTS

An 8-year-old boy with acute myeloid leukemia (AML) received chemotherapy, but relapsed 3 months after discontinuation of treatment. Subsequent chemotherapy was ineffective, and then, while in non-complete remission, he developed pulmonary and cerebral mucormycosis. On gene analysis the fungus was identified as Lichtheimia ramosa. Cord blood transplantation was conducted in combination with high-dose liposomal amphotericin B therapy. He successfully achieved complete remission without progression of mucormycosis.

CONCLUSIONS

Stem cell transplantation could reduce the mortality of patients with hematologic disease who develop mucormycosis.

摘要

背景

毛霉病是最难治的侵袭性真菌感染之一,常导致免疫功能低下患者(如重度糖尿病患者和血液系统恶性肿瘤患者)发生致命感染。

方法

我们回顾性评估了干细胞移植对一名发生毛霉病的难治性急性髓系白血病(AML)患儿的疗效。

结果

一名8岁急性髓系白血病(AML)男孩接受了化疗,但在治疗中断3个月后复发。随后的化疗无效,在未完全缓解期间,他发生了肺和脑毛霉病。基因分析显示该真菌为分支犁头霉。进行了脐血移植并联合大剂量脂质体两性霉素B治疗。他成功实现完全缓解,毛霉病未进展。

结论

干细胞移植可降低发生毛霉病的血液病患者的死亡率。

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