内容紹介
Summary
A 59-year-old female was diagnosed as pulmonary aspergillosis(IPA)while remission induction therapy for Philadelphia chromosome-positive acute lymphoblastic leukemia. Liposomal amphotericin B improved the fungal serodiagnostic markers, however, the IPA worsened. She also developed an Aspergillus brain abscess, which, while being undetectable on CT, was detected as multiple nodular lesions by MRI. A definitive diagnosis was made by polymerase chain reaction(PCR)of brain biopsy specimens. Voriconazole(VRCZ)was effective, and cord blood transplantation was performed. She has received VRCZ for a long time. There are no relapse of either the IPA or the Aspergillus brain abscess.
要旨
症例は59歳,女性。フィラデルフィア染色体陽性急性リンパ性白血病の寛解導入療法施行中に侵襲性肺アスペルギルス症(IPA)を発症した。liposomal amphotericin Bの投与により真菌血清補助診断の値は改善するもIPAは増悪した。また,アスペルギルス脳膿瘍も併発したがCTでは検出できずMRIで多発結節病変として検出した。脳生検の検体のPCR法で確定診断した。voriconazole(VRCZ)が奏効し,臍帯血移植を施行した。移植後約2年経過するが,VRCZの長期投与によりIPAとアスペルギルス脳膿瘍の再燃は認めていない。
目次
癌と化学療法 TOPへ
癌と化学療法 46巻7号 2019年7月号トップへ
【症例】
▶A Case of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia with Aspergillus Brain Abscess and Invasive Pulmonary Aspergillosis Successfully Treated with Voriconazole Followed by Cord Blood Transplantation 関口康宣ほか
A 59-year-old female was diagnosed as pulmonary aspergillosis(IPA)while remission induction therapy for Philadelphia chromosome-positive acute lymphoblastic leukemia. Liposomal amphotericin B improved the fungal serodiagnostic markers, however, the IPA worsened. She also developed an Aspergillus brain abscess, which, while being undetectable on CT, was detected as multiple nodular lesions by MRI. A definitive diagnosis was made by polymerase chain reaction(PCR)of brain biopsy specimens. Voriconazole(VRCZ)was effective, and cord blood transplantation was performed. She has received VRCZ for a long time. There are no relapse of either the IPA or the Aspergillus brain abscess.
要旨
症例は59歳,女性。フィラデルフィア染色体陽性急性リンパ性白血病の寛解導入療法施行中に侵襲性肺アスペルギルス症(IPA)を発症した。liposomal amphotericin Bの投与により真菌血清補助診断の値は改善するもIPAは増悪した。また,アスペルギルス脳膿瘍も併発したがCTでは検出できずMRIで多発結節病変として検出した。脳生検の検体のPCR法で確定診断した。voriconazole(VRCZ)が奏効し,臍帯血移植を施行した。移植後約2年経過するが,VRCZの長期投与によりIPAとアスペルギルス脳膿瘍の再燃は認めていない。