Disseminated tuberculosis following second unrelated cord blood transplantation for acute myelogenous leukemia

Transplant Infectious Disease - Tập 11 Số 1 - Trang 75-77 - 2009
Takahiro Shima1, Goichi Yoshimoto1, Toshihiro Miyamoto2, Shuro Yoshida1, Kenjiro Kamezaki1, Katsuto Takenaka1, Hiromi Iwasaki2, Naoki Harada1, Koji Nagafuji1, Takanori Teshima2, Nobuyuki Shimono1, Koichi Akashi1
1Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
2Center for Cellular and Molecular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan

Tóm tắt

Abstract: Here we report the case of a 43‐year‐old Japanese woman with acute myelogenous leukemia who underwent 2 unrelated cord blood transplantations (UCBT), terminating in fatal disseminated tuberculosis (TB). The patient did not achieve remission despite intensive chemotherapy, and subsequently underwent UCBT with a standard conditioning regimen. However, engraftment was not achieved. Fifty days after the first UCBT, the patient underwent a second UCBT with a reduced‐intensity conditioning regimen. She developed a pre‐engraftment immune reaction, which responded well to prednisolone, and engraftment was documented. However, 50 days after the second UCBT, the patient presented with high fever and developed pneumonia despite antibiotic and antifungal treatments. Thereafter, Mycobacterium tuberculosis was detected in blood cultures and specimens of bronchoalveolar lavage, thus indicating disseminated TB. Despite anti‐tuberculous treatment, she died on day 85. TB should always be considered as a possible diagnosis when treating febrile immunocompromised patients.

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Thông tin xuất bản

Transplant Infectious Disease

Tập 11 Số 1

75-77

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