New world cutaneous leishmaniasis in a traveler: The first documented case in the Philippines

We describe New World cutaneous leishmaniasis (Leishmania amazonensis), a disease not endemic in the Philippines, in a 45-year-old man with ulcerating lesions on his hand and leg ater returning from South America. The patient responded to treatment with liposomal amphotericin B. This imported case of leishmaniasis highlights the importance of obtaining a detailed travel history in patients with chronic, non-healing skin lesions which should lead to earlier recognition and treatment.

Sibling and unrelated allogeneic hematopoietic stem cell transplantation for multiple myeloma patients under 45-year-old at early stage / 白血病·淋巴瘤

Objective To evaluate the effectiveness and side effects in sibling and unrelated HLA identical allogeneic hematopoietic stem cell transplantation for multiple myeloma patients under 45-year-old at early stage. Methods Three patients with multiple myeloma ranged from 38 to 44-year-old received two courses of chemotherapies and achieved partial remission. Sibling HLA identical allogeneic hematopoietic stem cell transplantations were underwent in case 1 and 2, and unrelated were in case 3. The conditioning regimens for case 1 and 2 included fludarabine, busulfan plus cyclophosphamide, and of case 3 included modified busulfan, cyclophosphamide plus antithymocyte globulin. Cycloporine A combined with methotrexate were used to prevent GVHD in the case 1 and 2, and methotrexate, mycophenolate and cycloporine A were used in case 3. Results All patients achieved full donor chimerism without graft failure. Grade Ⅱ acute GVHD and extensive chronic GVHD were found in case 1, but not in case 2 and 3. The period of follow-up of case 1, 2 and 3 were 48, 27 and 6 months, respectively, and all of them were alive with no signs of relapse. Conclusion The multiple myeloma patients under 45-year-old underwent sibling and unrelated HLA identical allogeneic hematopoietic stem cell transplantation at early stage after chemotherapy remission have the low treatment-related mortality, high complete remission rate and may prolong long-term survival.