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Disseminated tuberculosis following second unrelated cord blood transplantation for acute myelogenous leukemia
Author(s) -
Shima T.,
Yoshimoto G.,
Miyamoto T.,
Yoshida S.,
Kamezaki K.,
Takenaka K.,
Iwasaki H.,
Harada N.,
Nagafuji K.,
Teshima T.,
Shimono N.,
Akashi K.
Publication year - 2009
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/j.1399-3062.2008.00354.x
Subject(s) - medicine , tuberculosis , surgery , regimen , pathology
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.