11/61. Pneumonitis due to corynebacterium equi.corynebacterium equi, a known cause of pneumonitis in foals, calves, and swine, was isolated from the sputum and bronchial washings of a child with pneumonitis and leukemia. Clinical improvement followed the administration of chloramphenicol, and cultures of sputum specimens were sterile until relapse occurred after antibiotic therapy was terminated. Cure was achieved with a second course of chloramphenicol therapy. corynebacterium equi was not isolated from 1,181 samples of sputum from other immunosuppressed children with cancer.- - - - - - - - - - ranking = 1keywords = leukemia (Clic here for more details about this article) |
12/61. A case of smoldering acute leukemia: long survival duration of 3 years and 9 months after the diagnosis.A typical case of smoldering acute leukemia has been followed up for long-standing course. This 73 year-old woman survived 3 years and 9 months after diagnosis of acute myelogenous leukemia. The hematological study on admission showed hypoplastic bone marrow with 51.6% of abnormal myeloblasts, although a few myeloblasts were seen in the peripheral blood. Intensive anti-leukemia chemotherapy was withheld during the whole course except on the terminal acute phase. Three episodes of pneumonia occurred and then, the proliferation of leukemic cells subsided concomitnantly after the exacerbation of infection. The direct and/or host-mediated anti-tumor effect by infectious organism was suggestive in this case. The labeling index with 3H-TdR of leukemic cells was 4.9%, suggesting the slow multiplication. Positive tuberculin reactivity and normal ratio of lymphocyte blastogenesis confirmed the preserved cellular immunity. These factors might be considered to be closely related with the smoldering course of this particular case.- - - - - - - - - - ranking = 7keywords = leukemia (Clic here for more details about this article) |
13/61. legionella lansingensis sp. nov. isolated from a patient with pneumonia and underlying chronic lymphocytic leukemia.A legionella-like organism, strain 1677-MI-H, was isolated from the bronchoscopy washings of a patient with pneumonia who had a 2-year history of progressive, chronic lymphocytic leukemia. The growth characteristics, cellular fatty acids, and ubiquinone content of the isolate were consistent with those for legionella spp. The isolate was serologically distinct in the slide agglutination test with absorbed antisera. dna hybridization studies showed that strain 1677-MI-H (ATCC 49751) represents a new legionella species which is named legionella lansingensis.- - - - - - - - - - ranking = 5keywords = leukemia (Clic here for more details about this article) |
14/61. bronchiolitis obliterans organizing pneumonia as a complication of allogeneic bone marrow transplantation.We report a patient who underwent two allogeneic bone marrow transplants for chronic myelogenous leukemia, initially in 1984 and again after relapse in 1990, who developed an identical pulmonary syndrome at a similar interval following each transplant. The patient presented with a non-productive cough, bilateral inspiratory crackles, and multiple patchy infiltrates on chest X-ray. Pulmonary function testing revealed a restrictive abnormality but no obstructive defects. The appearance of this pulmonary disorder after each transplant coincided with the development of chronic graft-versus-host disease. In both instances, this pulmonary syndrome completely reversed with corticosteroid therapy. The patient's chest computed tomographic scan and lung biopsy specimens were consistent with the diagnosis of bronchiolitis obliterans with organizing pneumonia (BOOP). While bronchiolitis obliterans has been reported following allogeneic transplant, BOOP has not previously been reported in this setting.- - - - - - - - - - ranking = 1keywords = leukemia (Clic here for more details about this article) |
15/61. Successful treatment with nonmyeloablative allogeneic hematopoietic stem cell transplantation in a patient with acute myeloid leukemia complicated with pulmonary infection.We describe the case of a 48-year-old man with acute myeloid leukemia complicated with pulmonary infection that was successfully treated by nonmyeloablative allogeneic peripheral blood stem cell transplantation with conditioning by low-dose total body irradiation and fludarabine. The disease was diagnosed immunophenotypically as myeloid/natural killer cell precursor acute leukemia. After two courses of induction therapy, complete remission was achieved. However, the patient developed pneumonia from prolonged severe neutropenia. Nonmyeloablative allogeneic transplantation was performed because of the active pulmonary infection and the patient's poor performance status. Myelosuppression after transplantation was mild, and the pulmonary infiltration was well controlled during the course of treatment. At the time of this report the patient was an outpatient in our clinic, and on day 500, his disease was in remission with well-controlled chronic graft-versus-host disease. Nonmyeloablative transplantation may provide a new therapeutic strategy for treating patients with active infection who cannot tolerate conventional transplantation with high-dose chemoradiotherapy.- - - - - - - - - - ranking = 6keywords = leukemia (Clic here for more details about this article) |
16/61. Acute lymphoblastic leukemia with hypereosinophilia: report of a case with 5q deletion and review of the literature.Peripheral blood eosinophilia as a presentation of acute lymphoblastic leukemia (ALL) has only rarely been reported. The eosinophilia is thought to be a nonneoplastic reaction to the neoplastic lymphoblasts. We present the case of a 5-year-old girl who developed peripheral hypereosinophilia with no circulating blasts prior to her diagnosis of B-cell lineage ALL. Cytogenetic study showed a hyperdiploid blast population with 5q deletion. Persistent peripheral hypereosinophilia should always be fully investigated, the possibility of a malignancy including ALL needs to be excluded, even in the absence of peripheral cytopenias and circulating blasts.- - - - - - - - - - ranking = 5keywords = leukemia (Clic here for more details about this article) |
17/61. Granulocytic sarcoma presenting as pneumonia in a child with t(8;21) acute myelogenous leukemia: diagnosis by fluorescent in situ hybridization.Granulocytic sarcoma is a soft tissue collection of leukemic cells. The authors describe a 4-year-old boy with M2 acute myelogenous leukemia (AML) who presented with fever, mild nonproductive cough, and hematemesis. Although he was initially diagnosed with nodular pneumonia, rapid resolution of a pulmonary infiltrate following induction chemotherapy was suggestive of a pulmonary granulocytic sarcoma. interphase fluorescent in situ hybridization (FISH) of the lung biopsy specimen for the t(8;21)(q22;q22) translocation confirmed the retrospective diagnosis of a well-differentiated pulmonary granulocytic sarcoma. Pulmonary granulocytic sarcomas may be underrecognized in children with AML; this may delay anti-leukemic therapy and may lead to ineffective therapy if misdiagnosed as pneumonia.- - - - - - - - - - ranking = 5keywords = leukemia (Clic here for more details about this article) |
18/61. aspergillus fumigatus, a rare cause of fatal coronary artery occlusion.endocarditis by Aspergillus species in patients without prior cardiovascular surgery is extremely rare and difficult to diagnose. We report and discuss a 69-year-old patient with hairy cell leukemia who developed severe bilateral pneumonia and metastatic subcutaneous nodules from which A. fumigatus was cultured. He died after 18 days of treatment with an adequate dose (0.7 mg/kg/day) of amphotericin b intravenously. Fungal endocarditis and a myocardial infarction due to a septic thrombotic occlusion of the left coronary artery by A. fumigatus appeared to be the cause of death. A. fumigatus could still be cultured from the aortic valve postmortem despite a total dose of 756 mg amphotericin b. In case of metastatic spread of Aspergillus spp., endocarditis should be suspected.- - - - - - - - - - ranking = 1keywords = leukemia (Clic here for more details about this article) |
19/61. Haunting appearance of bcr/abl fusion gene products in a patient with therapy related leukaemia.A 81-year-old man was diagnosed as multiple myeloma and had received melphalan for 6 years. After that, he developed acute myeloid leukemia (AML) with monosomy 7 and minor bcr/abl transcripts. fluorescence in situ hybridization identified no detectable level of bcr/abl rearrangement. During chemotherapy for AML, minor bcr/abl transcripts disappeared and instead major bcr/abl transcripts emerged. He died of pneumonia 3 months later. At that time, neither minor nor major bcr/abl transcripts were seen. These observations suggest that certain therapy related leukemia may be susceptible to generate very small clones with bcr/abl rearrangements.- - - - - - - - - - ranking = 2keywords = leukemia (Clic here for more details about this article) |
20/61. adult T-cell leukemia/lymphoma presenting as an acute noninfectious pneumonitis.A 29-year-old man presented with a four-week history of pneumonic symptoms and progressive roentenographic infiltrates which were unresponsive to orally administered antibiotics. bronchoscopy failed to identify an infectious etiology, but abundant atypical lymphocytes in the bronchial washings were present. A diagnosis of adult T-cell leukemia/lymphoma was subsequently made. After administration of cancer chemotherapy, the pneumonic symptoms and chest roentgenogram infiltrates resolved. This report suggests that ATL can present as an acute noninfectious pneumonitis.- - - - - - - - - - ranking = 5keywords = leukemia (Clic here for more details about this article) |
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