Hyun Su Kim; Se Hyung Kim; Hyun Jung Kim; Sang Cheol Lee; Sang Byung Bae; Chan Kyu Kim; Kyu Teak Lee; Seong Kyu Park; Jong Ho Won; Dae Sik Hong; Hee Sook Park; Eun Ju Choo

doi:10.5045/kjh.2009.44.4.289

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Kim, Kim, Kim, Lee, Bae, Kim, Lee, Park, Won, Hong, Park, and Choo: Successful Hematopoietic Stem Cell Transplantation in Myelodysplastic Syndrome with Invasive Fungal Infection – A Case Report –

Case Report

Korean J Hematol 2009;44(4):289-293.

Published online: 20 December 2009

DOI: https://doi.org/10.5045/kjh.2009.44.4.289

Successful Hematopoietic Stem Cell Transplantation in Myelodysplastic Syndrome with Invasive Fungal Infection – A Case Report –

Hyun Su Kim, M.D.¹, Se Hyung Kim, M.D.¹, Hyun Jung Kim, M.D.¹, Sang Cheol Lee, M.D.¹, Sang Byung Bae, M.D.¹, Chan Kyu Kim, M.D.¹, Kyu Teak Lee, M.D.¹, Seong Kyu Park, M.D.^1,, Jong Ho Won, M.D.¹, Dae Sik Hong, M.D.¹, Hee Sook Park, M.D.¹, Eun Ju Choo, M.D.²

¹Department of Hematology-Oncology, Soonchunhyang University School of Medicine, Bucheon, Korea

²Department of Infection, Soonchunhyang University School of Medicine, Bucheon, Korea

Correspondence to：Seong Kyu Park, M.D. Department of Internal Medicine, Division of Hematology & Oncology, Soonchunhyang University Bucheon Hospital 1174, Jung-dong, Wonmi-gu, Bucheon 420-853, Korea Tel: ＋82-32-621-5185, Fax: ＋82-32-621-5018 E-mail: skpark@schbc.ac.kr

Received 19 October 2009 Revised 8 December 2009 Accepted 11 December 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Myelodysplastic syndrome (MDS) is a heterogeneous group of disorders characterized by ineffective hematopoiesis, morphological dysplasia, peripheral blood cytopenias, and progressive bone marrow failure. The only proven curative treatment for MDS is hematopoietic stem cell transplantation. However, invasive fungal infection following hematopoietic stem cell transplantation has become the leading cause of death from infection. Therefore, transplant candidates with previous invasive fungal infection have often been excluded from the transplant program due to high risk of reactivation and associated death. We report on a case involving an MDS patient with complications from invasive aspergillosis who had shown no response to amphotericin-B. The patient underwent successfully unrelated allogeneic hematopoietic stem cell transplantation.

Keywords: Myelodysplastic syndrome, Hematopoietic stem cell transplantation, Aspergillosis

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Fig. 1.

(A) Computed tomography (CT) after use of amphotericin-B, shows peribronchial consolidative lesion with inner necrosis in right middle lobe (RML) and right lower lobe (RLL) around major fissure. (B) CT after use of voriconazole, shows decreased extent of peribronchial consolidative lesion with inner necrosis in RML and RLL around major fissure. (C) CT after stem cell transplantation, shows improved peribronchial consolidative lesion with liquefaction of previous necrotic material in RML and RLL around major fissure.

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