播散性黏液疽与 T 细胞耗竭异体干细胞移植--一个不寻常的病例研究。

IF 1.7 4区 医学 Q3 HEMATOLOGY Acta Haematologica Pub Date : 2024-08-21 DOI:10.1159/000540640
Oana Diana Dragoi, Mili Shah, Victoria Potter, Daniele Avenoso, Pramila Krishnamurthy, Alireza Abdolrasouli, Silke Schelenz, Julie Chandra, Varun Mehra
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引用次数: 0

摘要

导言:侵袭性真菌感染(IFI)是血液恶性肿瘤患者发病和死亡的主要原因:我们描述了一名 69 岁急性髓性白血病(AML)复发患者侵袭性粘孢子菌病(IM)的不寻常临床和放射学表现。患者在完成异基因造血干细胞移植(HSCT)的诱导和桥接化疗后,被诊断为播散性粘孢子菌病,受累部位不典型,包括中枢神经系统(CNS)、肺、脾、肌肉、骨和心脏。她的临床表现不典型,轻微的神经症状在两个月内缓慢发展,没有相应的全身炎症症状。最终,支气管肺泡灌洗液和硬膜下采集物证实为粘孢子菌:本报告强调了治疗免疫功能低下患者播散性骨髓瘤的艰巨性,在多学科专家的密切护理下,治疗取得了成功,随后患者接受了T细胞耗竭异基因造血干细胞移植,以治疗高风险血液恶性肿瘤。
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Disseminated Mucormycosis and T-Cell-Depleted Allogeneic Stem Cell Transplantation: An Unusual Case Study.

Introduction: Invasive fungal infections are a primary cause of morbidity and mortality in patients with haematological malignancies.

Case presentation: We describe an unusual clinical and radiological presentation of invasive mucormycosis (IM) in a 69-year-old patient with relapsed acute myeloid leukaemia. The patient was diagnosed with disseminated IM with involvement of the central nervous system in an atypical location, lung, spleen, muscle, bone, and heart, after having completed induction and bridging chemotherapy to allogeneic haematopoietic stem cell transplant (HSCT). Her clinical presentation was atypical with mild neurological symptoms slowly progressing over 2 months and without appropriate signs of systemic inflammation. Mucorales was eventually confirmed from bronchoalveolar lavage and subdural collection.

Conclusion: This report highlights the difficult challenges of managing disseminated IM in an immunocompromised patient, where close multidisciplinary specialist care enabled successful treatment, followed by T-cell-depleted allogeneic HSCT for a high-risk haematological malignancy.

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来源期刊
Acta Haematologica
Acta Haematologica 医学-血液学
CiteScore
4.90
自引率
0.00%
发文量
61
审稿时长
6-12 weeks
期刊介绍: ''Acta Haematologica'' is a well-established and internationally recognized clinically-oriented journal featuring balanced, wide-ranging coverage of current hematology research. A wealth of information on such problems as anemia, leukemia, lymphoma, multiple myeloma, hereditary disorders, blood coagulation, growth factors, hematopoiesis and differentiation is contained in first-rate basic and clinical papers some of which are accompanied by editorial comments by eminent experts. These are supplemented by short state-of-the-art communications, reviews and correspondence as well as occasional special issues devoted to ‘hot topics’ in hematology. These will keep the practicing hematologist well informed of the new developments in the field.
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