Acute monoblastic leukemia with t(10;11)(p12;q23) presenting with pulmonary involvement: a case report and literature review.

A forty-three-year-old Thai man presented with acute fever and dyspnea for one week with bilateral patchy infiltration, pancytopenia with monoblast. Bone marrow study was consistent with acute monoblastic leukemia. Lung lesions rapidly progressed to acute respiratory failure, which required intubation. Bronchoscopy with bronchoalveolar lavage revealed monotonous monoblast infiltration. Induction chemotherapy with 7 + 3 regimen was administered to halt the progression of leukemic pulmonary infiltration. Although there was clinical improvement, the chest radiograph developed crescent formation in the right upper lung field. Invasive pulmonary aspergillosis was suspected and successfully treated with antifungal agent. After peripheral blood recovery, bone marrow evaluation was performed and complete remission was established. HLA matching was sent to prepare for hematopoietic stem cell transplantation (HSCT). The literature review showed that the appropriate treatment for the patients with t(10;11)(p12;q23) was HSCT, but there was no data concerning correlation of t(10;11)(p12;q23) and pulmonary infiltration. This may be due to the low incidence of leukemic infiltration of acute leukemia patients, which is 0.48% and 3.06% in acute myeloid leukemia and acute monoblastic leukemia, respectively.

Cytokine production in NK and NKT cells from Mycobacterium tuberculosis infected patients.

Tuberculosis, a major health problem in developing countries, has re-emerged in recent years in many countries. While it is accepted that various lymphocyte subsets are important responses to mycobacterial infection, the roles of NK and NKT cells in producing cytokines are still unclear. Thus we have evaluated, in Mycobacterium tuberculosis infection, the frequency of cytokine producing cells by flow cytometry. Of 30 individuals examined, 17 had clinical evidence of pulmonary tuberculosis while the rest showed no evidence of infection. Patients had a significantly higher number of IFN-gamma and IL-4-producing T cells compared to control subjects, but the ratio of IFN-gamma to IL-4-producing T cells was similar in both groups. There were no differences between cytokine profiles of NK cells in patients and control subjects. A significant increase in the number of NKT cells was observed in patients. A striking finding was the higher frequency of IL-4-producing NKT cells compared to IFN-gamma-producing cells. Moreover, individual NKT cell produced both IFN-gamma and IL-4. The preferential type of Thl or Th2 cells is due to mycobacterial strain, type of antigen presenting cells and stage of disease, all of which can lead to different patterns of cytokine production by variety of lymphocyte subsets.