Department of Hematology and Oncology, Nara Prefecture General Medical Center, Japan.
Department of Blood Transfusion Medicine, Nara Medical University, Japan.
Intern Med. 2024 Jul 15;63(14):2069-2076. doi: 10.2169/internalmedicine.1181-22. Epub 2023 Dec 11.
A 63-year-old woman with adult T-cell leukemia (ATL) lymphomatous type developed a mild dry cough. Computed tomography revealed lung lesions with a tree-in-bud appearance during intensive chemotherapy. Antibodies against Mycobacterium avium complex were positive. Bronchoalveolar lavage culture showed growth of M. abscessus complex. Finally, M. abscessus subsp. massiliense was also identified. Sequential use of antimicrobials, including macrolides, was introduced during intensive chemotherapy, and the patient successfully underwent allogeneic hematopoietic stem cell transplantation (AHSCT). This is the first case report of a patient with ATL complicated by M. massiliense lung infection, who was successfully treated with haploidentical AHSCT using various combinations of antimicrobials.
一位 63 岁患有成人 T 细胞白血病(ATL)淋巴瘤型的女性患者出现轻度干性咳嗽。在强化化疗期间,计算机断层扫描显示肺部病变呈树芽征。抗鸟分枝杆菌复合体抗体阳性。支气管肺泡灌洗培养显示脓肿分枝杆菌复合体生长。最终,也鉴定出脓肿分枝杆菌亚种。在强化化疗期间,联合使用包括大环内酯类在内的多种抗生素进行了序贯治疗,患者成功接受了异基因造血干细胞移植(AHSCT)。这是首例报道的 ATL 合并脓肿分枝杆菌肺感染的患者,通过使用各种抗生素组合的单倍体相合 AHSCT 成功治疗。